Provider Demographics
NPI:1194884106
Name:RENO, DENNIS ROBERT (DC)
Entity type:Individual
Prefix:DR
First Name:DENNIS
Middle Name:ROBERT
Last Name:RENO
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 E GROVER ST
Mailing Address - Street 2:
Mailing Address - City:SHELBY
Mailing Address - State:NC
Mailing Address - Zip Code:28150-3918
Mailing Address - Country:US
Mailing Address - Phone:704-480-1700
Mailing Address - Fax:704-480-1708
Practice Address - Street 1:210 E GROVER ST
Practice Address - Street 2:
Practice Address - City:SHELBY
Practice Address - State:NC
Practice Address - Zip Code:28150-3918
Practice Address - Country:US
Practice Address - Phone:704-480-1700
Practice Address - Fax:704-480-1708
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-06
Last Update Date:2009-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1798111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC890875BMedicaid
NC890875BMedicaid
NC2450609AMedicare ID - Type Unspecified