Provider Demographics
NPI:1942368287
Name:NOE, RICHARD NICK JR (DC)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:NICK
Last Name:NOE
Suffix:JR
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:PO BOX 1246
Mailing Address - Street 2:
Mailing Address - City:NORRIS
Mailing Address - State:TN
Mailing Address - Zip Code:37828
Mailing Address - Country:US
Mailing Address - Phone:865-463-2273
Mailing Address - Fax:865-463-7572
Practice Address - Street 1:134 WEST BROAD ST
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:TN
Practice Address - Zip Code:37716
Practice Address - Country:US
Practice Address - Phone:865-463-2273
Practice Address - Fax:865-463-7572
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-05
Last Update Date:2011-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1866111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN4039227OtherBCBS
TN7152487OtherCIGNA
TN4039227OtherBCBS