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General NPI Number Information
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NPI Number | 1285888727
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Entity Type | Organization
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Legal Business Name | RAPIDS CHIROPRACTIC AND WELLNESS SC
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Dates
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Enumeration Date | 11/11/2008
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Last Update Date | 06/19/2013
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Provider Practice Location Address
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Address Line | 750 DEWEY ST
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City | WISCONSIN RAPIDS
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State | WI
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Zip | 54494-5216
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Country | US
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Telephone | 715-423-3020
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Fax | 715-423-3012
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Provider Business Mailing Address
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Address Line | 750 DEWEY ST
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City | WISCONSIN RAPIDS
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State | WI
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Zip | 54494-5216
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Country | US
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Telephone | 715-423-3020
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Fax | 715-423-3012
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Authorized Official
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Title or Position | CHIROPRACTOR/PRESIDENT
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Name | DR. DENNIS REAK
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Credential | D.C.
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Telephone | 715-423-3020
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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 | 4244-12
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License Number State | WI
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