Richard E Pettit, D.C.
Individual provider Active NPI Chiropractor · Greenwich, OH
NPI 1154328540 · NPPES record last updated Nov 23, 2011
Key facts
- NPI
- 1154328540
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Chiropractor 111N00000X
- License
- 132 (OH)
- Practice address
- 19 Townsend St
Greenwich, OH 44837-1131 - Phone
- (419) 752-4905
- Fax
- (419) 752-4905
- NPI assigned
- Jun 30, 2005
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 132 | OH | Yes |
Addresses
Primary practice location
19 Townsend St
Greenwich, OH 44837-1131
Mailing address
19 Townsend St
Greenwich, OH 44837-1131
Phone (419) 752-4905
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 34117335800 | Other | OH | WORKERS COMPENSATION |
| 0232108 | Medicaid | OH |
Other providers in Greenwich, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 23, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.