MEDICARE: DR. RICHARD ALBERT BOATRIGHT DC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	5129	AZ

General Provider Information

NPI Number	:	1821075524
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RICHARD ALBERT BOATRIGHT DC

Provider Business Mailing Address
First Line	:	PO BOX 3330
Second Line	:
City	:	PINETOP
State	:	AZ
Zip	:	85935-3330
Country	:	US
Telephone Number	:	928-367-4402
Fax Number	:	928-367-4403

Provider Business Practice Location Address
First Line	:	43 W WHITE MOUNTAIN BLVD
Second Line	:	SUITE C
City	:	PINETOP
State	:	AZ
Zip	:	85935-7060
Country	:	US
Telephone Number	:	928-367-4402
Fax Number	:	928-367-4403

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/23/2005
Last Update Date	:	07/08/2007

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Directions to “ DR. RICHARD ALBERT BOATRIGHT DC” Practice Location

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