Provider Demographics
NPI:1780763722
Name:KNIPPING, RICHARD WARD III (DC)
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:WARD
Last Name:KNIPPING
Suffix:III
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 1:90 MAIN AVE
Mailing Address - Street 2:
Mailing Address - City:GARDINER
Mailing Address - State:ME
Mailing Address - Zip Code:04345-2176
Mailing Address - Country:US
Mailing Address - Phone:207-582-2222
Mailing Address - Fax:207-588-0891
Practice Address - Street 1:90 MAIN AVE
Practice Address - Street 2:
Practice Address - City:GARDINER
Practice Address - State:ME
Practice Address - Zip Code:04345-2176
Practice Address - Country:US
Practice Address - Phone:207-582-2222
Practice Address - Fax:207-588-0891
Is Sole Proprietor?:No
Enumeration Date:2006-11-02
Last Update Date:2013-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECR1294111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MM9277Medicare ID - Type Unspecified
MEMM9277Medicare PIN