Healthcare Provider Details

I. General information

NPI: 1467325019
Provider Name (Legal Business Name): CHRISTOPHER REOPELLE LADC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/29/2025
Last Update Date: 09/29/2025
Certification Date: 09/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18277 RIDDLE RD NE
BEMIDJI MN
56601-7578
US

IV. Provider business mailing address

18277 RIDDLE RD NE
BEMIDJI MN
56601-7578
US

V. Phone/Fax

Practice location:
  • Phone: 218-766-5304
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: