Provider Demographics
NPI:1306904115
Name:CHURA, RICHARD EMIL (DC)
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:EMIL
Last Name:CHURA
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 1:145 N STATE AVE
Mailing Address - Street 2:
Mailing Address - City:ALPENA
Mailing Address - State:MI
Mailing Address - Zip Code:49707-2835
Mailing Address - Country:US
Mailing Address - Phone:989-356-4126
Mailing Address - Fax:989-354-8715
Practice Address - Street 1:2477 US HIGHWAY 23 S STE C
Practice Address - Street 2:
Practice Address - City:ALPENA
Practice Address - State:MI
Practice Address - Zip Code:49707-4610
Practice Address - Country:US
Practice Address - Phone:989-356-4126
Practice Address - Fax:989-354-8715
Is Sole Proprietor?:No
Enumeration Date:2006-12-05
Last Update Date:2022-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301004958111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI2301005008OtherSTATE LICENSE NUMBER
MI950Z45008OtherBCBSM ID NUMBER
MIRC004958OtherBCBSM LICENSE NUMBER
MIRC004958OtherBCBSM LICENSE NUMBER
MIT33891Medicare UPIN