Provider Demographics
NPI:1033177076
Name:ECKLES, RICHARD CHARLES (DC)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:CHARLES
Last Name:ECKLES
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 1:717 N. 18TH ST.
Mailing Address - Street 2:SUITE 6
Mailing Address - City:CENTERVILLE
Mailing Address - State:IA
Mailing Address - Zip Code:52544
Mailing Address - Country:US
Mailing Address - Phone:641-856-9165
Mailing Address - Fax:
Practice Address - Street 1:717 N. 18TH ST.
Practice Address - Street 2:SUITE 6
Practice Address - City:CENTERVILLE
Practice Address - State:IA
Practice Address - Zip Code:52544
Practice Address - Country:US
Practice Address - Phone:641-856-9165
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-01
Last Update Date:2017-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA06882111N00000X
GACHIR008112111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
V10820Medicare UPIN
35ZCJZWMedicare Oscar/Certification