MEDICARE: DR. RICHARD WILLIAMS D.C.

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	1520	NM

General Provider Information

NPI Number	:	1902981756
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RICHARD WILLIAMS D.C.

Provider Business Mailing Address
First Line	:	1135 S MAIN ST
Second Line	:	SUITE C
City	:	LAS CRUCES
State	:	NM
Zip	:	88005-2946
Country	:	US
Telephone Number	:	575-541-9288
Fax Number	:	575-526-3828

Provider Business Practice Location Address
First Line	:	1135 S MAIN ST
Second Line	:	SUITE C
City	:	LAS CRUCES
State	:	NM
Zip	:	88005-2946
Country	:	US
Telephone Number	:	575-541-9288
Fax Number	:	575-526-3828

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

Provider Enumeration Date	:	10/26/2006
Last Update Date	:	07/24/2013

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