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General NPI Number Information
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NPI Number | 1679543144
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Entity Type | Individual
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Provider Name | SUSAN ELAINE RICHARDS DC
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Gender | Female
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Dates
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Enumeration Date | 01/25/2006
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Last Update Date | 07/09/2007
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Provider Practice Location Address
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Address Line | 2000 GENERAL BOOTH BLVD SUITE #101
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City | VIRGINIA BEACH
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State | VA
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Zip | 23454-5876
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Country | US
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Telephone | 757-430-0990
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Fax | 757-430-6860
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Provider Business Mailing Address
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Address Line | 4639 GLENCOE LN
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City | VIRGINIA BEACH
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State | VA
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Zip | 23464-6373
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Country | US
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Telephone | 757-309-6679
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 2558
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 0104556450
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License Number State | VA
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