Provider Demographics
NPI:1467772574
Name:RIECHERT, JESSICA MERISSA (DC)
Entity Type:Individual
Prefix:DR
First Name:JESSICA
Middle Name:MERISSA
Last Name:RIECHERT
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12753 S PARKER RD
Mailing Address - Street 2:STE 103
Mailing Address - City:PARKER
Mailing Address - State:CO
Mailing Address - Zip Code:80134-3485
Mailing Address - Country:US
Mailing Address - Phone:720-851-9694
Mailing Address - Fax:303-840-7073
Practice Address - Street 1:12753 S PARKER RD
Practice Address - Street 2:STE 103
Practice Address - City:PARKER
Practice Address - State:CO
Practice Address - Zip Code:80134-3485
Practice Address - Country:US
Practice Address - Phone:720-851-9694
Practice Address - Fax:303-840-7073
Is Sole Proprietor?:No
Enumeration Date:2010-06-11
Last Update Date:2010-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO6399111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor