Provider Demographics
NPI:1255661260
Name:RICHARDS, MICHAEL CHAD (DC)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:CHAD
Last Name:RICHARDS
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 1:1101 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
Is Sole Proprietor?:Yes
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?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor