Individual
DR. JIMMY A REIDT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
17 5TH AVE, SHELL LAKE, WI 54871
(715) 468-2275
Mailing address
PO BOX 637, SHELL LAKE, WI 54871-0637
(715) 468-2275
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2861
WI
111N00000X
Chiropractor
3069
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
38867700
—
WI
Enumeration date
01/23/2007
Last updated
06/21/2013
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