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NPI Code Detail

MEDICARE: DR. PAUL ANDREW RICHETTO D.C.

MEDICARE: DR. PAUL ANDREW RICHETTO 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
1111N00000XChiropractor7873AZ
2111NR0400XRehabilitation Chiropractor4562AZ

General Provider Information

NPI Number : 1467632760
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. PAUL ANDREW RICHETTO D.C.
Provider Business Mailing Address
First Line : 5445 DTC PKWY STE 1130
Second Line :
City : GREENWOOD VILLAGE
State : CO
Zip : 80111-3038
Country : US
Telephone Number : 720-749-5599
Fax Number : 720-925-5897
Provider Business Practice Location Address
First Line : 2222 W DUNLAP AVE STE 190
Second Line :
City : PHOENIX
State : AZ
Zip : 85021-2800
Country : US
Telephone Number : 602-584-9661
Fax Number : 720-925-5897
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/05/2007
Last Update Date : 03/12/2024

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