MEDICARE: ADAM RENELT, D.C., P.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	1122	SD

General Provider Information

NPI Number	:	1134301765
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADAM RENELT, D.C., P.C.

Provider Business Mailing Address
First Line	:	4301 W 57TH ST STE 140
Second Line	:
City	:	SIOUX FALLS
State	:	SD
Zip	:	57108-2255
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4301 W 57TH ST STE 140
Second Line	:
City	:	SIOUX FALLS
State	:	SD
Zip	:	57108-2255
Country	:	US
Telephone Number	:	605-271-5717
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. ADAM RENELT
Credential	:	D.C.
Telephone Number	:	605-271-5717

Provider Enumeration Date	:	12/05/2007
Last Update Date	:	03/17/2009

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