Individual
DEAN GLENN RENNEKE
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
DC
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
1572
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
70855RE
BLUE CROSS BLUE SHIELD
MN
Enumeration date
05/19/2006
Last updated
07/08/2007
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