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NPI Code Detail

MEDICARE: DR. RICHARD EDWARD HARKENRIDER DC

MEDICARE: DR. RICHARD EDWARD HARKENRIDER DC
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
1111N00000XChiropractor08001383IN

General Provider Information

NPI Number : 1700913696
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. RICHARD EDWARD HARKENRIDER DC
Provider Business Mailing Address
First Line : 816 MILL LAKE ROAD
Second Line :
City : FORT WAYNE
State : IN
Zip : 46845-6400
Country : US
Telephone Number : 260-637-1548
Fax Number : 260-637-1548
Provider Business Practice Location Address
First Line : 816 MILL LAKE RD
Second Line :
City : FORT WAYNE
State : IN
Zip : 46845-6400
Country : US
Telephone Number : 260-637-1548
Fax Number : 260-637-1548
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/27/2007
Last Update Date : 07/08/2007

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