Provider Demographics
NPI:1356430771
Name:RICHTER, DANIEL L (DC)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:L
Last Name:RICHTER
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 1:120 N EAST ST
Mailing Address - Street 2:
Mailing Address - City:TIPTON
Mailing Address - State:IN
Mailing Address - Zip Code:46072-1740
Mailing Address - Country:US
Mailing Address - Phone:765-675-3755
Mailing Address - Fax:
Practice Address - Street 1:120 N EAST ST
Practice Address - Street 2:
Practice Address - City:TIPTON
Practice Address - State:IN
Practice Address - Zip Code:46072-1740
Practice Address - Country:US
Practice Address - Phone:765-675-3755
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN08001332111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN810900Medicare ID - Type Unspecified