Provider Demographics
NPI:1023137924
Name:RIESCHL, CHANDRA MILLER (DC)
Entity type:Individual
Prefix:DR
First Name:CHANDRA
Middle Name:MILLER
Last Name:RIESCHL
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:103 W 2ND ST
Mailing Address - Street 2:
Mailing Address - City:CHASKA
Mailing Address - State:MN
Mailing Address - Zip Code:55318-1907
Mailing Address - Country:US
Mailing Address - Phone:952-368-9958
Mailing Address - Fax:952-368-9959
Practice Address - Street 1:103 W 2ND ST
Practice Address - Street 2:
Practice Address - City:CHASKA
Practice Address - State:MN
Practice Address - Zip Code:55318-1907
Practice Address - Country:US
Practice Address - Phone:952-368-9958
Practice Address - Fax:952-368-9959
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-29
Last Update Date:2018-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN3675111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor