Provider Demographics
NPI:1932446101
Name:REIF, SHANNON RACHELLE (DC)
Entity Type:Individual
Prefix:DR
First Name:SHANNON
Middle Name:RACHELLE
Last Name:REIF
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:825 N 6TH ST
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:IA
Mailing Address - Zip Code:52601-4920
Mailing Address - Country:US
Mailing Address - Phone:319-754-4671
Mailing Address - Fax:319-754-7273
Practice Address - Street 1:825 N 6TH ST
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:IA
Practice Address - Zip Code:52601-4920
Practice Address - Country:US
Practice Address - Phone:319-754-4671
Practice Address - Fax:319-754-7273
Is Sole Proprietor?:No
Enumeration Date:2013-01-08
Last Update Date:2014-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA007541111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor