Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 129557 | AK |
NPI | 1003319476 |
---|---|
Provider Name | Dr. Zachary Richards |
First Address | Palmer, AK 99645-9075 |
Second Address | Palmer, AK 99645 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/03/2018 |
Last Update Date | 13/03/2018 |