Provider Demographics
NPI:1619104932
Name:BEHLEN, RICHARD DUANE (DC)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:DUANE
Last Name:BEHLEN
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 1:2350 W SHAW AVE STE 127
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93711-3400
Mailing Address - Country:US
Mailing Address - Phone:559-236-3004
Mailing Address - Fax:619-560-5455
Practice Address - Street 1:2350 W SHAW AVE STE 127
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93711-3400
Practice Address - Country:US
Practice Address - Phone:559-236-3004
Practice Address - Fax:619-560-5455
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-12
Last Update Date:2019-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA17622111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor