Provider Demographics
NPI:1962573188
Name:RICH, TERRIE ANN (DC)
Entity type:Individual
Prefix:DR
First Name:TERRIE
Middle Name:ANN
Last Name:RICH
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:967 W LIBERTY ST
Mailing Address - Street 2:
Mailing Address - City:HUBBARD
Mailing Address - State:OH
Mailing Address - Zip Code:44425-1336
Mailing Address - Country:US
Mailing Address - Phone:330-534-5770
Mailing Address - Fax:330-534-5650
Practice Address - Street 1:967 W LIBERTY ST
Practice Address - Street 2:
Practice Address - City:HUBBARD
Practice Address - State:OH
Practice Address - Zip Code:44425-1336
Practice Address - Country:US
Practice Address - Phone:330-534-5770
Practice Address - Fax:330-534-5650
Is Sole Proprietor?:No
Enumeration Date:2006-11-10
Last Update Date:2010-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2203111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0242571Medicaid
OHRI0801421Medicare ID - Type Unspecified
OH0242571Medicaid