Provider Demographics
NPI:1124115522
Name:RIVERS, RICHARD JAMES (DC)
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:JAMES
Last Name:RIVERS
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 1:1 N CENTER ST
Mailing Address - Street 2:
Mailing Address - City:SEBEWAING
Mailing Address - State:MI
Mailing Address - Zip Code:48759-1406
Mailing Address - Country:US
Mailing Address - Phone:989-883-9090
Mailing Address - Fax:989-883-2132
Practice Address - Street 1:1 N CENTER ST
Practice Address - Street 2:
Practice Address - City:SEBEWAING
Practice Address - State:MI
Practice Address - Zip Code:48759-1406
Practice Address - Country:US
Practice Address - Phone:989-883-9090
Practice Address - Fax:989-883-2132
Is Sole Proprietor?:No
Enumeration Date:2006-10-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301008166111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor