Individual
JOHN CHARLES REDEBAUGH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
5314 NISSWA AVE, NISSWA, MN 56474
(218) 963-2944
(219) 963-0899
Mailing address
PO BOX 689, NISSWA, MN 56468-0689
(218) 963-2944
(218) 963-0899
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
1512
MN
Other
Enumeration date
10/13/2006
Last updated
07/08/2007
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