Healthcare Provider Details
I. General information
NPI: 1003735903
Provider Name (Legal Business Name): KINETIC CHIROPRACTIC & REHAB LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/14/2026
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
112 E WALNUT ST
RIVER FALLS WI
54022-2439
US
IV. Provider business mailing address
2104 HUNTER HILL CT
HUDSON WI
54016-5824
US
V. Phone/Fax
- Phone: 715-425-0333
- Fax:
- Phone: 262-875-0177
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QC0050X |
| Taxonomy | Critical Access Hospital Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
JACOB
FLEGNER
Title or Position: MANAGING MEMBER
Credential: DC
Phone: 262-875-0177