Provider Demographics
NPI:1730252727
Name:SCHECHTER, RICHARD (DC)
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:
Last Name:SCHECHTER
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 1:868 GRAVENSTEIN HWY N
Mailing Address - Street 2:
Mailing Address - City:SEBASTOPOL
Mailing Address - State:CA
Mailing Address - Zip Code:95472-2810
Mailing Address - Country:US
Mailing Address - Phone:707-823-4511
Mailing Address - Fax:
Practice Address - Street 1:868 GRAVENSTEIN HWY N
Practice Address - Street 2:
Practice Address - City:SEBASTOPOL
Practice Address - State:CA
Practice Address - Zip Code:95472-2810
Practice Address - Country:US
Practice Address - Phone:707-823-4511
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA12820111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
T04922Medicare UPIN
DC0128200Medicare ID - Type Unspecified