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Ty Rebedew

Chiropractor in Berlin, WI. Individual provider (NPI-1).

NPI number1073100178
StatusActive
Last updated in NPPESMar 23, 2023

Details

NPI
1073100178
Entity type
Individual (NPI-1)
Name
Ty Rebedew
Sex
Male
Sole proprietor
Yes
Enumeration date
Dec 23, 2020
Certification date
Mar 23, 2023
Last updated
Mar 23, 2023

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
111N00000X Chiropractor3306-12WIYes

Practice location

147 N State St
Berlin, WI 54923-1621

Phone 920-361-3515 · Fax 920-361-2733

Mailing address

147 N State St
Berlin, WI 54923-1621

Phone 920-361-3515 · Fax 920-361-2733

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