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General NPI Number Information
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NPI Number | 1174814685
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Entity Type | Organization
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Legal Business Name | RAQUELLE BAINTER INC
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Dates
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Enumeration Date | 05/02/2011
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Last Update Date | 07/06/2011
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Provider Practice Location Address
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Address Line | 303 W MAIN ST
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City | HILL CITY
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State | KS
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Zip | 67642-1927
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Country | US
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Telephone | 785-657-7104
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 553
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City | HOXIE
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State | KS
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Zip | 67740-0553
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Country | US
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Telephone | 785-657-7104
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. RAQUELLE BAINTER
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Credential | D.C.
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Telephone | 785-657-7104
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 01-05370
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License Number State | KS
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