Provider Demographics
NPI:1992291850
Name:REINECKE MEDICAL AND CHIROPRACTIC CENTER
Entity type:Organization
Organization Name:REINECKE MEDICAL AND CHIROPRACTIC CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KRASIMIR
Authorized Official - Middle Name:
Authorized Official - Last Name:HRISTOV
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:773-837-0915
Mailing Address - Street 1:602 E COLLEGE BLVD
Mailing Address - Street 2:
Mailing Address - City:ROSWELL
Mailing Address - State:NM
Mailing Address - Zip Code:88201-7529
Mailing Address - Country:US
Mailing Address - Phone:575-623-3155
Mailing Address - Fax:
Practice Address - Street 1:400 E COLLEGE BLVD STE E
Practice Address - Street 2:
Practice Address - City:ROSWELL
Practice Address - State:NM
Practice Address - Zip Code:88201-7570
Practice Address - Country:US
Practice Address - Phone:575-623-3155
Practice Address - Fax:575-623-3677
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-03
Last Update Date:2025-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty