Provider Demographics
NPI:1235185372
Name:WURZLER, RICHARD LYNN (DC)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:LYNN
Last Name:WURZLER
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 1:1901 JESS PARRISH CT
Mailing Address - Street 2:
Mailing Address - City:TITUSVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32796-2146
Mailing Address - Country:US
Mailing Address - Phone:321-268-1999
Mailing Address - Fax:321-264-2440
Practice Address - Street 1:1901 JESS PARRISH CT
Practice Address - Street 2:
Practice Address - City:TITUSVILLE
Practice Address - State:FL
Practice Address - Zip Code:32796-2146
Practice Address - Country:US
Practice Address - Phone:321-268-1999
Practice Address - Fax:321-264-2440
Is Sole Proprietor?:No
Enumeration Date:2006-05-26
Last Update Date:2012-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH0005832111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL380152700Medicaid
FL22249Medicare ID - Type Unspecified
FLT94033Medicare UPIN