Provider Demographics
NPI:1467792044
Name:SARCHENKO, RICHARD A (DC)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:A
Last Name:SARCHENKO
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 1:1525 N MAIN ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:BOUNTIFUL
Mailing Address - State:UT
Mailing Address - Zip Code:84010-6166
Mailing Address - Country:US
Mailing Address - Phone:801-292-1200
Mailing Address - Fax:
Practice Address - Street 1:1525 N MAIN ST
Practice Address - Street 2:SUITE 100
Practice Address - City:BOUNTIFUL
Practice Address - State:UT
Practice Address - Zip Code:84010-6166
Practice Address - Country:US
Practice Address - Phone:801-292-1200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-02-19
Last Update Date:2013-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT8547239-1202111N00000X
MO2013002496111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor