Provider Demographics
NPI:1154651164
Name:RICHARDS CHIROPRACTIC SPINE & JOINT CENTER, INC.
Entity Type:Organization
Organization Name:RICHARDS CHIROPRACTIC SPINE & JOINT CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:CHAD
Authorized Official - Last Name:RICHARDS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:812-883-1444
Mailing Address - Street 1:1101 N JIM DAY RD
Mailing Address - Street 2:SUITE 113
Mailing Address - City:SALEM
Mailing Address - State:IN
Mailing Address - Zip Code:47167-5200
Mailing Address - Country:US
Mailing Address - Phone:812-883-1444
Mailing Address - Fax:812-883-8119
Practice Address - Street 1:1101 N JIM DAY RD
Practice Address - Street 2:SUITE 113
Practice Address - City:SALEM
Practice Address - State:IN
Practice Address - Zip Code:47167-5200
Practice Address - Country:US
Practice Address - Phone:812-883-1444
Practice Address - Fax:812-883-8119
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-14
Last Update Date:2010-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN08002495A111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty