Provider Demographics
NPI:1548328982
Name:WINTERS, RICHARD ALAN (DC)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:ALAN
Last Name:WINTERS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:322 W HOBSONWAY
Mailing Address - Street 2:STE. 1
Mailing Address - City:BLYTHE
Mailing Address - State:CA
Mailing Address - Zip Code:92225-1652
Mailing Address - Country:US
Mailing Address - Phone:760-922-3434
Mailing Address - Fax:
Practice Address - Street 1:322 W HOBSONWAY
Practice Address - Street 2:STE. 1
Practice Address - City:BLYTHE
Practice Address - State:CA
Practice Address - Zip Code:92225-1652
Practice Address - Country:US
Practice Address - Phone:760-922-3434
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC12102111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAT04625Medicare UPIN
CADC0121020Medicare ID - Type Unspecified