Healthcare Provider Details

I. General information

NPI: 1811980923
Provider Name (Legal Business Name): STEVEN P REINEN D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/24/2005
Last Update Date: 03/20/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

115 ENTERPRISE DR
VERONA WI
53593-9122
US

IV. Provider business mailing address

439 CROSS COUNTRY RD
VERONA WI
53593-1909
US

V. Phone/Fax

Practice location:
  • Phone: 608-845-8860
  • Fax:
Mailing address:
  • Phone: 608-845-8544
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number111N00000X
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: