Healthcare Provider Details

I. General information

NPI: 1063488039
Provider Name (Legal Business Name): RICHARD LEE VAN VOORHIS D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/28/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

223 W MAIN ST
NEWCOMERSTOWN OH
43832-1042
US

IV. Provider business mailing address

223 W MAIN ST
NEWCOMERSTOWN OH
43832-1042
US

V. Phone/Fax

Practice location:
  • Phone: 740-498-8551
  • Fax: 740-498-4754
Mailing address:
  • Phone: 740-498-8551
  • Fax: 740-498-4754

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NN0400X
TaxonomyNeurology Chiropractor
License NumberDC3108
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: