Provider Demographics
NPI:1467505453
Name:RICE, WILLIAM MICHAEL (DC)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:MICHAEL
Last Name:RICE
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 1:108 SRP DRIVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:EVANS
Mailing Address - State:GA
Mailing Address - Zip Code:30809-3319
Mailing Address - Country:US
Mailing Address - Phone:706-860-4001
Mailing Address - Fax:706-860-6520
Practice Address - Street 1:108 SRP DRIVE
Practice Address - Street 2:SUITE A
Practice Address - City:EVANS
Practice Address - State:GA
Practice Address - Zip Code:30809-3319
Practice Address - Country:US
Practice Address - Phone:706-860-4001
Practice Address - Fax:706-860-6520
Is Sole Proprietor?:No
Enumeration Date:2007-01-21
Last Update Date:2016-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR004942111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000638756BMedicaid
GA000638786AMedicaid
35ZCCQCMedicare PIN
GA000638756BMedicaid
GA511G700863Medicare PIN