MEDICARE: DR. SHANNON RACHELLE REIF 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	007541	IA

General Provider Information

NPI Number	:	1932446101
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SHANNON RACHELLE REIF D.C.

Provider Business Mailing Address
First Line	:	825 N 6TH ST
Second Line	:
City	:	BURLINGTON
State	:	IA
Zip	:	52601-4920
Country	:	US
Telephone Number	:	319-754-4671
Fax Number	:	319-754-7273

Provider Business Practice Location Address
First Line	:	825 N 6TH ST
Second Line	:
City	:	BURLINGTON
State	:	IA
Zip	:	52601-4920
Country	:	US
Telephone Number	:	319-754-4671
Fax Number	:	319-754-7273

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

Provider Enumeration Date	:	01/08/2013
Last Update Date	:	01/24/2014

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