Provider Demographics
NPI:1598062416
Name:OESTERRITTER, RICHARD BRENT (DC)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:BRENT
Last Name:OESTERRITTER
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:PO BOX 1530
Mailing Address - Street 2:
Mailing Address - City:NOME
Mailing Address - State:AK
Mailing Address - Zip Code:99762-1530
Mailing Address - Country:US
Mailing Address - Phone:859-333-8489
Mailing Address - Fax:
Practice Address - Street 1:113 EAST FRONT ST
Practice Address - Street 2:SUITE 102 B1530
Practice Address - City:NOME
Practice Address - State:AK
Practice Address - Zip Code:99762
Practice Address - Country:US
Practice Address - Phone:907-443-7477
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-02-14
Last Update Date:2012-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK548111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor