Organization
DEAN G RENNEKE, DC, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEAN GLENN RENNEKE (OWNER)
(218) 829-5380
Entity
Organization
Contact information
Practice address
623 MADISON ST, BRAINERD, MN 56401-4518
(218) 829-5380
(218) 825-0972
Mailing address
623 MADISON ST, BRAINERD, MN 56401-4518
(218) 829-5380
(218) 825-0972
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
183
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
52777RE
BLUE CROSS BLUE SHIELD
MN
Enumeration date
05/19/2006
Last updated
08/22/2020
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