MEDICARE: DR. LISA PATRICIA REID D.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	3494	WI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	20-0493747014	OTHER	WI	BLUE CROSS/BLUE SHIELD

General Provider Information

NPI Number	:	1568461283
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LISA PATRICIA REID D.C.

Provider Business Mailing Address
First Line	:	9735 W SAINT MARTINS RD
Second Line	:
City	:	FRANKLIN
State	:	WI
Zip	:	53132-9830
Country	:	US
Telephone Number	:	262-682-4131
Fax Number	:

Provider Business Practice Location Address
First Line	:	9735 W SAINT MARTINS RD
Second Line	:
City	:	FRANKLIN
State	:	WI
Zip	:	53132-9624
Country	:	US
Telephone Number	:	414-525-9895
Fax Number	:	414-525-9927

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/14/2005
Last Update Date	:	08/10/2017

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