MEDICARE: DR. SHARI LEE RICHARD 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
1	111N00000X	Chiropractor	001239	CT

General Provider Information

NPI Number	:	1962537837
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SHARI LEE RICHARD DC

Provider Business Mailing Address
First Line	:	PO BOX 1206
Second Line	:
City	:	SOUTH WINDSOR
State	:	CT
Zip	:	06074-7206
Country	:	US
Telephone Number	:	860-290-1598
Fax Number	:

Provider Business Practice Location Address
First Line	:	352R MIDDLE TPKE W
Second Line	:
City	:	MANCHESTER
State	:	CT
Zip	:	06040-3824
Country	:	US
Telephone Number	:	860-290-1598
Fax Number	:	860-643-1603

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/22/2007
Last Update Date	:	07/09/2007

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