Provider Demographics
NPI:1720278583
Name:REDDEL CHIROPRACTIC INC.
Entity type:Organization
Organization Name:REDDEL CHIROPRACTIC INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:REDDEL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:510-558-8258
Mailing Address - Street 1:1398 SOLANO AVE
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:CA
Mailing Address - Zip Code:94706-1855
Mailing Address - Country:US
Mailing Address - Phone:510-558-8258
Mailing Address - Fax:
Practice Address - Street 1:1398 SOLANO AVE
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:CA
Practice Address - Zip Code:94706-1855
Practice Address - Country:US
Practice Address - Phone:510-558-8258
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-27
Last Update Date:2007-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC 24834261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service