Provider Demographics
NPI:1285888727
Name:RAPIDS CHIROPRACTIC AND WELLNESS SC
Entity type:Organization
Organization Name:RAPIDS CHIROPRACTIC AND WELLNESS SC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:
Authorized Official - Last Name:REAK
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:715-423-3020
Mailing Address - Street 1:750 DEWEY ST
Mailing Address - Street 2:
Mailing Address - City:WISCONSIN RAPIDS
Mailing Address - State:WI
Mailing Address - Zip Code:54494-5216
Mailing Address - Country:US
Mailing Address - Phone:715-423-3020
Mailing Address - Fax:715-423-3012
Practice Address - Street 1:750 DEWEY ST
Practice Address - Street 2:
Practice Address - City:WISCONSIN RAPIDS
Practice Address - State:WI
Practice Address - Zip Code:54494-5216
Practice Address - Country:US
Practice Address - Phone:715-423-3020
Practice Address - Fax:715-423-3012
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:RAPIDS CHIROPRACTIC AND WELLNESS SC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-11-11
Last Update Date:2013-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4244-12111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty