MEDICARE: DR. REBECCA LYNN GNAS 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	4931-12	WI
2	111N00000X	Chiropractor	4931	WI

General Provider Information

NPI Number	:	1730512286
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. REBECCA LYNN GNAS D.C.

Provider Business Mailing Address
First Line	:	1613 S RANCH RD
Second Line	:
City	:	NEW BERLIN
State	:	WI
Zip	:	53151-1652
Country	:	US
Telephone Number	:	414-510-1263
Fax Number	:

Provider Business Practice Location Address
First Line	:	530 N 108TH PL STE 100
Second Line	:
City	:	WAUWATOSA
State	:	WI
Zip	:	53226-4253
Country	:	US
Telephone Number	:	414-510-1263
Fax Number	:

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

Provider Enumeration Date	:	08/19/2013
Last Update Date	:	12/26/2023

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