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General NPI Number Information
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NPI Number | 1619376779
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Entity Type | Organization
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Legal Business Name | ROBERT M RICHARDS, D.C., P.C.
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Dates
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Enumeration Date | 08/14/2014
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Last Update Date | 08/14/2014
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Provider Practice Location Address
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Address Line | 790 ANDERSON AVE
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City | COOS BAY
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State | OR
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Zip | 97420-4627
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Country | US
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Telephone | 541-808-0999
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Fax |
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Provider Business Mailing Address
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Address Line | 790 ANDERSON AVE
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City | COOS BAY
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State | OR
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Zip | 97420-4627
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Country | US
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Telephone | 541-808-0999
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. ROBERT MICHAEL RICHARDS
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Credential | DC
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Telephone | 541-808-0999
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 2500
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License Number State | OR
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