Provider Demographics
NPI:1972221083
Name:HERNANDEZ, ERICK ALEXANDER (DC)
Entity Type:Individual
Prefix:DR
First Name:ERICK
Middle Name:ALEXANDER
Last Name:HERNANDEZ
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 1:801 N PERKINS ST
Mailing Address - Street 2:
Mailing Address - City:RUSHVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46173-1206
Mailing Address - Country:US
Mailing Address - Phone:847-239-4875
Mailing Address - Fax:
Practice Address - Street 1:2500 NATIONAL RD W
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:IN
Practice Address - Zip Code:47374-4628
Practice Address - Country:US
Practice Address - Phone:847-239-4875
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-16
Last Update Date:2022-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN08003310A111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor