Provider Demographics
NPI:1447302559
Name:RINEHART, JERI W (DC)
Entity type:Individual
Prefix:MR
First Name:JERI
Middle Name:W
Last Name:RINEHART
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:513 PENN ST
Mailing Address - Street 2:
Mailing Address - City:HUNTINGDON
Mailing Address - State:PA
Mailing Address - Zip Code:16652-1621
Mailing Address - Country:US
Mailing Address - Phone:814-643-4546
Mailing Address - Fax:
Practice Address - Street 1:513 PENN ST
Practice Address - Street 2:
Practice Address - City:HUNTINGDON
Practice Address - State:PA
Practice Address - Zip Code:16652-1621
Practice Address - Country:US
Practice Address - Phone:814-643-4546
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC004979L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PARI404507Medicare ID - Type Unspecified
PAU51588Medicare UPIN