Provider Demographics
NPI:1427183649
Name:SPARACINO, RICHARD (DC)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:
Last Name:SPARACINO
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 1:235 W GIACONDA WAY
Mailing Address - Street 2:#227
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85704-4340
Mailing Address - Country:US
Mailing Address - Phone:520-293-3892
Mailing Address - Fax:520-293-3898
Practice Address - Street 1:235 W GIACONDA WAY
Practice Address - Street 2:#227
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85704-4340
Practice Address - Country:US
Practice Address - Phone:520-293-3892
Practice Address - Fax:520-293-3898
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-21
Last Update Date:2012-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ3286111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ23103286OtherSTATE COMP
AZAZ0086220OtherBC BS