MEDICARE: DR. JUSTIN MICHAEL REINER DC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	1152	SD

General Provider Information

NPI Number	:	1679703649
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JUSTIN MICHAEL REINER DC

Provider Business Mailing Address
First Line	:	5032 S BUR OAK PL
Second Line	:	120
City	:	SIOUX FALLS
State	:	SD
Zip	:	57108-2243
Country	:	US
Telephone Number	:	605-999-9071
Fax Number	:

Provider Business Practice Location Address
First Line	:	5032 S BUR OAK PL
Second Line	:	120
City	:	SIOUX FALLS
State	:	SD
Zip	:	57108-2243
Country	:	US
Telephone Number	:	605-999-9071
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/23/2009
Last Update Date	:	07/23/2009

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