Provider Demographics
NPI:1811980923
Name:REINEN, STEVEN P (DC)
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:P
Last Name:REINEN
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 1:439 CROSS COUNTRY RD
Mailing Address - Street 2:
Mailing Address - City:VERONA
Mailing Address - State:WI
Mailing Address - Zip Code:53593-1909
Mailing Address - Country:US
Mailing Address - Phone:608-845-8544
Mailing Address - Fax:
Practice Address - Street 1:115 ENTERPRISE DR
Practice Address - Street 2:
Practice Address - City:VERONA
Practice Address - State:WI
Practice Address - Zip Code:53593-9122
Practice Address - Country:US
Practice Address - Phone:608-845-8860
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-08-24
Last Update Date:2013-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI111N00000X111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI38774100Medicaid
WIT63090Medicare UPIN
WI38774100Medicaid