Provider Demographics
NPI:1407014616
Name:BETTS, RICHARD (DC)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:
Last Name:BETTS
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 1:1392 LAKE BALDWIN LN
Mailing Address - Street 2:STE B
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32814-6668
Mailing Address - Country:US
Mailing Address - Phone:407-894-8388
Mailing Address - Fax:407-894-8389
Practice Address - Street 1:1392 LAKE BALDWIN LN
Practice Address - Street 2:STE B
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32814-6668
Practice Address - Country:US
Practice Address - Phone:407-894-8388
Practice Address - Fax:407-894-8389
Is Sole Proprietor?:No
Enumeration Date:2008-05-26
Last Update Date:2009-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH 9347111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor