Provider Demographics
NPI:1730158122
Name:POWERS, RICHARD MICHAEL (DC)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:MICHAEL
Last Name:POWERS
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 1:10625 N MILITARY TRAIL
Mailing Address - Street 2:SUITE 203
Mailing Address - City:PALM BEACH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33410-6552
Mailing Address - Country:US
Mailing Address - Phone:561-622-6244
Mailing Address - Fax:561-622-4083
Practice Address - Street 1:10625 N MILITARY TRL
Practice Address - Street 2:SUITE 203
Practice Address - City:PALM BEACH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33410-6552
Practice Address - Country:US
Practice Address - Phone:561-622-6244
Practice Address - Fax:561-622-4083
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-16
Last Update Date:2015-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH0003372111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLT55857Medicare UPIN
FL88504Medicare ID - Type Unspecified