Provider Demographics
NPI:1548911050
Name:WANNINGER, RACHEL (DC)
Entity type:Individual
Prefix:DR
First Name:RACHEL
Middle Name:
Last Name:WANNINGER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1444 NW 124TH CT
Mailing Address - Street 2:
Mailing Address - City:CLIVE
Mailing Address - State:IA
Mailing Address - Zip Code:50325-8150
Mailing Address - Country:US
Mailing Address - Phone:515-278-2782
Mailing Address - Fax:
Practice Address - Street 1:1444 NW 124TH CT
Practice Address - Street 2:
Practice Address - City:CLIVE
Practice Address - State:IA
Practice Address - Zip Code:50325-8150
Practice Address - Country:US
Practice Address - Phone:515-729-3425
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-17
Last Update Date:2022-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA112163111NI0900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NI0900XChiropractic ProvidersChiropractorInternist