Provider Demographics
NPI:1750306544
Name:HELTON, RICHARD DENNIS (DC)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:DENNIS
Last Name:HELTON
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 1:1715 BERGLUND LN STE 104
Mailing Address - Street 2:
Mailing Address - City:VIERA
Mailing Address - State:FL
Mailing Address - Zip Code:32940-6230
Mailing Address - Country:US
Mailing Address - Phone:321-751-5351
Mailing Address - Fax:321-751-5370
Practice Address - Street 1:1715 BERGLUND LN STE 104
Practice Address - Street 2:
Practice Address - City:VIERA
Practice Address - State:FL
Practice Address - Zip Code:32940-6230
Practice Address - Country:US
Practice Address - Phone:321-751-5351
Practice Address - Fax:321-751-5370
Is Sole Proprietor?:No
Enumeration Date:2006-07-13
Last Update Date:2024-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLHC7647111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
34990Medicare ID - Type Unspecified
U84121Medicare UPIN