MEDICARE: DR. DANIEL K REINBOLDT 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	DC5056	TX

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	4324263	OTHER	TX	AETNA
3	8H3830	OTHER	TX	BCBS

General Provider Information

NPI Number	:	1689856213
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DANIEL K REINBOLDT D.C.

Provider Business Mailing Address
First Line	:	2806 MITCHELL ST
Second Line	:
City	:	GREENVILLE
State	:	TX
Zip	:	75402-8939
Country	:	US
Telephone Number	:	903-454-2225
Fax Number	:

Provider Business Practice Location Address
First Line	:	2806 MITCHELL ST
Second Line	:
City	:	GREENVILLE
State	:	TX
Zip	:	75402-8939
Country	:	US
Telephone Number	:	903-454-2225
Fax Number	:

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

Provider Enumeration Date	:	12/05/2007
Last Update Date	:	12/05/2007

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