Provider Demographics
NPI:1508148743
Name:RICHARDSON CHIROPRACTIC & WELLNESS, LLC
Entity Type:Organization
Organization Name:RICHARDSON CHIROPRACTIC & WELLNESS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:STEPHEN
Authorized Official - Last Name:RICHARDSON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:781-659-8150
Mailing Address - Street 1:340 WASHINGTON ST
Mailing Address - Street 2:SUITE 6
Mailing Address - City:NORWELL
Mailing Address - State:MA
Mailing Address - Zip Code:02061-2045
Mailing Address - Country:US
Mailing Address - Phone:781-659-8150
Mailing Address - Fax:781-659-8140
Practice Address - Street 1:340 WASHINGTON ST
Practice Address - Street 2:SUITE 6
Practice Address - City:NORWELL
Practice Address - State:MA
Practice Address - Zip Code:02061-2045
Practice Address - Country:US
Practice Address - Phone:781-659-8150
Practice Address - Fax:781-659-8140
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-14
Last Update Date:2011-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3255111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty