Provider Demographics
NPI:1306807243
Name:SEMLOW, RICHARD LEE (DC)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:LEE
Last Name:SEMLOW
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 1:247 N MAIN ST STE A
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:MI
Mailing Address - Zip Code:48170-1238
Mailing Address - Country:US
Mailing Address - Phone:734-455-2145
Mailing Address - Fax:734-455-2825
Practice Address - Street 1:247 N MAIN ST
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:MI
Practice Address - Zip Code:48170-1238
Practice Address - Country:US
Practice Address - Phone:734-455-2145
Practice Address - Fax:734-455-2825
Is Sole Proprietor?:No
Enumeration Date:2006-03-30
Last Update Date:2024-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301007178111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0P16150001OtherMEDICARE ADVANTAGE
MI950F328340OtherBLUE CARE NETWORK
MI950F32834OtherBCBS
MI0P16150001OtherMEDICARE PLUS BLUE