Healthcare Provider Details

I. General information

NPI: 1174681472
Provider Name (Legal Business Name): RICHARD ALAN HAUSER DC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/05/2006
Last Update Date: 11/26/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

614 E SELTICE WAY SUITE A
POST FALLS ID
83854-6367
US

IV. Provider business mailing address

614 E SELTICE WAY SUITE A
POST FALLS ID
83854
US

V. Phone/Fax

Practice location:
  • Phone: 208-777-1638
  • Fax: 208-777-9100
Mailing address:
  • Phone: 208-777-1638
  • Fax: 208-777-9100

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCHIA846
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: