Provider Demographics
NPI:1295037141
Name:RICHARD R. BEHREND, INC
Entity Type:Organization
Organization Name:RICHARD R. BEHREND, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:R
Authorized Official - Last Name:BEHREND
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:417-682-2104
Mailing Address - Street 1:1201 POPLAR ST
Mailing Address - Street 2:
Mailing Address - City:LAMAR
Mailing Address - State:MO
Mailing Address - Zip Code:64759-1934
Mailing Address - Country:US
Mailing Address - Phone:417-682-2104
Mailing Address - Fax:417-682-2104
Practice Address - Street 1:1201 POPLAR ST
Practice Address - Street 2:
Practice Address - City:LAMAR
Practice Address - State:MO
Practice Address - Zip Code:64759-1934
Practice Address - Country:US
Practice Address - Phone:417-682-2104
Practice Address - Fax:417-682-2104
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-29
Last Update Date:2010-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOCE004259111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty