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Individual

DR. LOREN W. RICHIE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DC

Contact information

Practice address
2205 WABASH AVE, SUITE 107, SPRINGFIELD, IL 62704-5354
(217) 698-2779
(217) 698-7504
Mailing address
2205 WABASH AVE, SUITE 107, SPRINGFIELD, IL 62704-5354
(217) 698-2779
(217) 698-7504

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
038008580
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
P00344945
RAILROAD MEDICARE
IL
Enumeration date
07/19/2006
Last updated
10/02/2013
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