Provider Demographics
NPI:1669652079
Name:ACKERMAN, RICHARD THOMAS (DC)
Entity Type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:THOMAS
Last Name:ACKERMAN
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 1:2020 NORTH CHESTER AVE
Mailing Address - Street 2:#B
Mailing Address - City:BAKERFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93308
Mailing Address - Country:US
Mailing Address - Phone:661-397-0425
Mailing Address - Fax:661-392-7294
Practice Address - Street 1:2020 NORTH CHESTER AVE
Practice Address - Street 2:#B
Practice Address - City:BAKERFIELD
Practice Address - State:CA
Practice Address - Zip Code:93308
Practice Address - Country:US
Practice Address - Phone:661-397-0425
Practice Address - Fax:661-392-7294
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-14
Last Update Date:2007-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC15742111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor