Provider Demographics
NPI:1669593505
Name:BRECH, RICHARD A JR (DC)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:A
Last Name:BRECH
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 1:345 COURT ST
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02360-4329
Mailing Address - Country:US
Mailing Address - Phone:508-747-5617
Mailing Address - Fax:508-746-7881
Practice Address - Street 1:345 COURT ST
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02360-4329
Practice Address - Country:US
Practice Address - Phone:508-747-5617
Practice Address - Fax:508-746-7881
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA891111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MABRY35607OtherBLUE CROSS BLUE SHIELD
MABRY35607OtherBLUE CROSS BLUE SHIELD