Provider Demographics
NPI:1730302118
Name:REINER CHIROPRACTIC CLINIC PA
Entity type:Organization
Organization Name:REINER CHIROPRACTIC CLINIC PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRINCIPAL OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LAURIE
Authorized Official - Middle Name:ANN REINER
Authorized Official - Last Name:HUGHES
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:952-758-5135
Mailing Address - Street 1:201 MAIN ST E
Mailing Address - Street 2:
Mailing Address - City:NEW PRAGUE
Mailing Address - State:MN
Mailing Address - Zip Code:56071-1832
Mailing Address - Country:US
Mailing Address - Phone:952-758-5135
Mailing Address - Fax:952-758-5179
Practice Address - Street 1:201 MAIN ST E
Practice Address - Street 2:
Practice Address - City:NEW PRAGUE
Practice Address - State:MN
Practice Address - Zip Code:56071-1832
Practice Address - Country:US
Practice Address - Phone:952-758-5135
Practice Address - Fax:952-758-5179
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-11
Last Update Date:2018-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2331111N00000X
MN3360111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN00936REOtherBLUE CROSS OF MN
MN768582300Medicaid
DF7985OtherRAILROAD MEDICARE
MN768582300Medicaid