Healthcare Provider Details

I. General information

NPI: 1568539112
Provider Name (Legal Business Name): RICHARD CHATFIELD CHIROPRACTIC CLINIC, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/29/2006
Last Update Date: 11/01/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2803 CENTRAL DR
BEDFORD TX
76021-4812
US

IV. Provider business mailing address

2803 CENTRAL DR
BEDFORD TX
76021-4812
US

V. Phone/Fax

Practice location:
  • Phone: 817-283-6100
  • Fax: 817-283-9536
Mailing address:
  • Phone: 817-283-6100
  • Fax: 817-283-9536

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number4326
License Number StateTX

VIII. Authorized Official

Name: DR. RICHARD GEORGE CHATFIELD
Title or Position: OWNER
Credential: DC
Phone: 817-283-6100