Provider Demographics
NPI:1851427496
Name:HULSE, RICHARD R (DC)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:R
Last Name:HULSE
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 1:1107 FAIRLAND AVE
Mailing Address - Street 2:
Mailing Address - City:PANAMA CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32401-1824
Mailing Address - Country:US
Mailing Address - Phone:850-215-1814
Mailing Address - Fax:850-872-9892
Practice Address - Street 1:3613 N HIGHWAY 231
Practice Address - Street 2:
Practice Address - City:PANAMA CITY
Practice Address - State:FL
Practice Address - Zip Code:32404-9743
Practice Address - Country:US
Practice Address - Phone:850-785-8311
Practice Address - Fax:850-872-9892
Is Sole Proprietor?:No
Enumeration Date:2007-02-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH8218111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLU91005Medicare UPIN