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General NPI Number Information
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NPI Number | 1942865902
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Entity Type | Organization
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Legal Business Name | RECHARGE CHIROPRACTIC LLC
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Dates
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Enumeration Date | 05/06/2019
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Last Update Date | 05/06/2019
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Provider Practice Location Address
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Address Line | 224 S MAIN ST
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City | RIVER FALLS
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State | WI
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Zip | 54022-2424
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Country | US
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Telephone | 715-257-0031
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Fax | 715-227-6664
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Provider Business Mailing Address
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Address Line | 224 S MAIN ST
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City | RIVER FALLS
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State | WI
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Zip | 54022-2424
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Country | US
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Telephone | 715-257-0031
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Fax | 715-227-6664
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Authorized Official
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Title or Position | OWNER
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Name | DR. CHRISTIAN NELDEBERG
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Credential | DC
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Telephone | 715-257-0031
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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 |
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License Number State |
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