Provider Demographics
NPI:1124186549
Name:KREIBICH, JAMES (DC)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:
Last Name:KREIBICH
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1951 WOODLANE DR STE 102
Mailing Address - Street 2:
Mailing Address - City:WOODBURY
Mailing Address - State:MN
Mailing Address - Zip Code:55125-3855
Mailing Address - Country:US
Mailing Address - Phone:651-502-1047
Mailing Address - Fax:651-846-6446
Practice Address - Street 1:1951 WOODLANE DR STE 102
Practice Address - Street 2:
Practice Address - City:WOODBURY
Practice Address - State:MN
Practice Address - Zip Code:55125-3855
Practice Address - Country:US
Practice Address - Phone:651-502-1047
Practice Address - Fax:651-846-6446
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-05
Last Update Date:2025-01-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4241111N00000X
MN4030111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor