Provider Demographics
NPI:1619376779
Name:ROBERT M RICHARDS, D.C., P.C.
Entity Type:Organization
Organization Name:ROBERT M RICHARDS, D.C., P.C.
Other - Org Name:FAMILY CHIROPRACTIC CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:RICHARDS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:541-808-0999
Mailing Address - Street 1:790 ANDERSON AVE
Mailing Address - Street 2:
Mailing Address - City:COOS BAY
Mailing Address - State:OR
Mailing Address - Zip Code:97420-4627
Mailing Address - Country:US
Mailing Address - Phone:541-808-0999
Mailing Address - Fax:
Practice Address - Street 1:790 ANDERSON AVE
Practice Address - Street 2:
Practice Address - City:COOS BAY
Practice Address - State:OR
Practice Address - Zip Code:97420-4627
Practice Address - Country:US
Practice Address - Phone:541-808-0999
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-14
Last Update Date:2014-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR2500111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty