# REBEL CHIROPRACTIC LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1104368026
- **Authorized official:** DR. JON SCHWANZ DC (OWNER)
- **Authorized official phone:** (419) 878-8142

## Contact information

- **Practice address:** 1222 PRAY BLVD STE 1, WATERVILLE, OH 43566-8717
- **Practice address phone:** (419) 878-8142
- **Practice address fax:** (419) 878-8143
- **Mailing address:** 1222 PRAY BLVD STE 1, WATERVILLE, OH 43566-8717
- **Mailing address phone:** (419) 878-8142
- **Mailing address fax:** (419) 878-8143

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 111N00000X | Chiropractor | 1201 | OH | Yes |

## Other

- **Enumeration date:** 11/09/2016
- **Last updated:** 09/18/2019