Provider Demographics
NPI:1760544167
Name:ALLEN, RICHARD DEAN (DC)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:DEAN
Last Name:ALLEN
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 1:1819 WARD DR
Mailing Address - Street 2:SUITE 102
Mailing Address - City:MURFREESBORO
Mailing Address - State:TN
Mailing Address - Zip Code:37129-0556
Mailing Address - Country:US
Mailing Address - Phone:615-217-2345
Mailing Address - Fax:615-217-2346
Practice Address - Street 1:1819 WARD DR
Practice Address - Street 2:SUITE 102
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37129-0556
Practice Address - Country:US
Practice Address - Phone:615-217-2345
Practice Address - Fax:615-217-2346
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-14
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1376111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3107387OtherBCBS
TN5243674OtherAETNA
TN6551571OtherCIGNA
TNU76889Medicare UPIN
TN3970340Medicare ID - Type UnspecifiedMEDICARE