Healthcare Provider Details

I. General information

NPI: 1710123013
Provider Name (Legal Business Name): TODD JAMES REHM D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/17/2008
Last Update Date: 12/17/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2309 ROUTE 9N REHM CHIROPRACTIC & MASSAGE CLINIC2309
LAKE GEORGE NY
12845
US

IV. Provider business mailing address

2309 RT 9N
LAKE GEORGE NY
12845
US

V. Phone/Fax

Practice location:
  • Phone: 518-668-2222
  • Fax: 518-668-5307
Mailing address:
  • Phone: 518-668-2222
  • Fax: 518-668-5307

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberX0083531
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: