Individual
TY REBEDEW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
147 N STATE ST, BERLIN, WI 54923-1621
(920) 361-3515
(920) 361-2733
Mailing address
147 N STATE ST, BERLIN, WI 54923-1621
(920) 361-3515
(920) 361-2733
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
3306-12
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5588-12
—
WI
Enumeration date
12/23/2020
Last updated
03/23/2023
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