Provider Demographics
NPI:1588709471
Name:RICHARDS, ERIC JOSEPH (DC,MS EXERCISE PHY)
Entity type:Individual
Prefix:DR
First Name:ERIC
Middle Name:JOSEPH
Last Name:RICHARDS
Suffix:
Gender:M
Credentials:DC,MS EXERCISE PHY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8256 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WOODSTOCK
Mailing Address - State:GA
Mailing Address - Zip Code:30188-5047
Mailing Address - Country:US
Mailing Address - Phone:770-517-2240
Mailing Address - Fax:770-517-2286
Practice Address - Street 1:8256 MAIN ST
Practice Address - Street 2:
Practice Address - City:WOODSTOCK
Practice Address - State:GA
Practice Address - Zip Code:30188-5047
Practice Address - Country:US
Practice Address - Phone:770-517-2240
Practice Address - Fax:770-517-2286
Is Sole Proprietor?:No
Enumeration Date:2007-02-20
Last Update Date:2016-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA006932111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA35ZCGQFMedicare ID - Type Unspecified
GAU88440Medicare UPIN