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General NPI Number Information
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NPI Number | 1992792337
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Entity Type | Individual
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Provider Name | RICKY REICH SIDES DC
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Gender | Male
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Dates
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Enumeration Date | 09/30/2005
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Last Update Date | 08/22/2022
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Provider Practice Location Address
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Address Line | 1570 WESTBROOK PLAZA DR
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City | WINSTON-SALEM
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State | NC
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Zip | 27103-1328
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Country | US
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Telephone | 386-774-0209
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Fax | 336-774-0905
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Provider Business Mailing Address
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Address Line | 1570 WESTBROOK PLAZA DR
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City | WINSTON-SALEM
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State | NC
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Zip | 27103-1328
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Country | US
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Telephone | 386-774-0209
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Fax | 336-774-0905
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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 | 1218
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License Number State | NC
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