Provider Demographics
NPI:1366824534
Name:SANDERS, RICHARD T (DC)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:T
Last Name:SANDERS
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:PO BOX 1645
Mailing Address - Street 2:
Mailing Address - City:HAUGHTON
Mailing Address - State:LA
Mailing Address - Zip Code:71037-1645
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:153 S ELM ST
Practice Address - Street 2:SUITE 300
Practice Address - City:HAUGHTON
Practice Address - State:LA
Practice Address - Zip Code:71037-9676
Practice Address - Country:US
Practice Address - Phone:318-927-0364
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-24
Last Update Date:2015-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1733111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor