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Ty Rebedew
Chiropractor in Berlin, Wisconsin
NPI 1073100178

Ty Rebedew is a Chiropractor based in Berlin, WI. Ty Rebedew practices in Berlin, WI. The NPI Number for Ty Rebedew is 1073100178 and holds a License No. 3306-12 (Wisconsin).

The current practice location address for Ty Rebedew is 147 N State St, Berlin, WI and can be reached out via phone at 920-361-3515 and via fax at 920-361-2733.

Location: 147 N State St, Berlin, WI, 54923-1621
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1073100178
Provider Name
Ty Rebedew
Credential
Provider Entity Type
Individual
Gender
Male
Address
147 N State St, Berlin, WI, 54923-1621
Phone Number
920-361-3515
Fax Number
920-361-2733
Provider Enumeration Date
12/23/2020
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
5588-12 05 WI
institution
Provider Business Practice Location Address Details
Address
147 N State St
City
Berlin
State
Wisconsin
Zip
54923-1621
Phone Number
920-361-3515
Fax Number
920-361-2733
person
Provider Business Mailing Address Details
Address
147 N State St
City
Berlin
State
Wisconsin
Zip
54923-1621
Phone Number
920-361-3515
Fax Number
920-361-2733
person
Provider's Taxonomy Details 1
Type
Chiropractic Providers
Classification
Chiropractor
Speciality
-
Taxonomy
111N00000X
License No.
3306-12 (Wisconsin)
Definition
A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems.
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