Provider Demographics
NPI:1821154840
Name:ZAHORIK, RICHARD DONALD (DC)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:DONALD
Last Name:ZAHORIK
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 1:4166 N OAKLAND AVENUE
Mailing Address - Street 2:
Mailing Address - City:SHOREWOOD
Mailing Address - State:WI
Mailing Address - Zip Code:53211-2026
Mailing Address - Country:US
Mailing Address - Phone:414-964-3465
Mailing Address - Fax:
Practice Address - Street 1:4166 N OAKLAND AVENUE
Practice Address - Street 2:
Practice Address - City:SHOREWOOD
Practice Address - State:WI
Practice Address - Zip Code:53211-2026
Practice Address - Country:US
Practice Address - Phone:414-964-3465
Practice Address - Fax:414-964-3035
Is Sole Proprietor?:No
Enumeration Date:2006-12-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3349012111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI38895000Medicaid
WI38895000Medicaid