Healthcare Provider Details
I. General information
NPI: 1902862592
Provider Name (Legal Business Name): REGIONAL HEALTH CENTER OF RICHMOND, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/24/2006
Last Update Date: 11/30/2023
Certification Date: 11/30/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
307 IVY AVE SE
RICHMOND MN
56368
US
IV. Provider business mailing address
307 IVY AVE SE
RICHMOND MN
56368
US
V. Phone/Fax
- Phone: 320-597-8999
- Fax: 320-597-8995
- Phone: 320-597-8999
- Fax: 320-597-8995
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 111N00000X |
| Taxonomy | Chiropractor |
| License Number | 003166 |
| License Number State | MN |
VIII. Authorized Official
Name:
JENNIFER
ANDREA
LOUREY
Title or Position: PRESIDENT/OWNER
Credential: DC
Phone: 203-210-1663