Provider Demographics
NPI:1114999653
Name:RACIOPPI, RICHARD NICHOLAS III (DC)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:NICHOLAS
Last Name:RACIOPPI
Suffix:III
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:108 OSPREY WAY
Mailing Address - Street 2:
Mailing Address - City:PHOENIXVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19460-1072
Mailing Address - Country:US
Mailing Address - Phone:610-948-1487
Mailing Address - Fax:610-948-1499
Practice Address - Street 1:108 OSPREY WAY
Practice Address - Street 2:
Practice Address - City:PHOENIXVILLE
Practice Address - State:PA
Practice Address - Zip Code:19460
Practice Address - Country:US
Practice Address - Phone:610-948-1487
Practice Address - Fax:610-948-1499
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-07
Last Update Date:2016-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC006718L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA223589983OtherTAX ID NUMBER