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NPI Code Detail

MEDICARE: DR. RICHARD SPENCER FAIRROW D.C.

MEDICARE:  DR. RICHARD SPENCER FAIRROW  D.C.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1111N00000XChiropractor3797MN

General Provider Information

NPI Number : 1144368077
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. RICHARD SPENCER FAIRROW D.C.
Provider Business Mailing Address
First Line : 261 RUTH ST N
Second Line :
City : SAINT PAUL
State : MN
Zip : 55119-4337
Country : US
Telephone Number : 651-714-4848
Fax Number : 651-739-8452
Provider Business Practice Location Address
First Line : 261 RUTH ST N
Second Line :
City : SAINT PAUL
State : MN
Zip : 55119-4337
Country : US
Telephone Number : 651-714-4848
Fax Number : 651-739-8452
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/02/2007
Last Update Date : 07/08/2007

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Directions to “ DR. RICHARD SPENCER FAIRROW D.C.” Practice Location

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