Individual
DR. RICHARD A DICENSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
372 S INDEPENDENCE BLVD, SUITE 105, VIRGINIA BEACH, VA 23452-1000
(757) 497-2748
(757) 497-2206
Mailing address
372 S INDEPENDENCE BLVD, SUITE 105, VIRGINIA BEACH, VA 23452-1000
(757) 497-2748
(757) 497-2206
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
0104001391
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
331613
ANTHEM PROVIDER
VA
Enumeration date
04/06/2007
Last updated
07/08/2007
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