Provider Demographics
NPI:1831356815
Name:VANHOUTEN, RICH (DC)
Entity type:Individual
Prefix:DR
First Name:RICH
Middle Name:
Last Name:VANHOUTEN
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 1:580 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:YOUNGSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:16371-1130
Mailing Address - Country:US
Mailing Address - Phone:814-563-4050
Mailing Address - Fax:
Practice Address - Street 1:580 E MAIN ST
Practice Address - Street 2:
Practice Address - City:YOUNGSVILLE
Practice Address - State:PA
Practice Address - Zip Code:16371-1130
Practice Address - Country:US
Practice Address - Phone:814-563-4050
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-19
Last Update Date:2008-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC4265L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA600402Medicare PIN