Provider Demographics
NPI:1447458195
Name:RICHTER, DANIEL W (DC)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:W
Last Name:RICHTER
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 1:1121 N LYNNDALE DR
Mailing Address - Street 2:SUITE A
Mailing Address - City:APPLETON
Mailing Address - State:WI
Mailing Address - Zip Code:54914-3012
Mailing Address - Country:US
Mailing Address - Phone:920-428-9190
Mailing Address - Fax:
Practice Address - Street 1:1121 N LYNNDALE DR
Practice Address - Street 2:SUITE A
Practice Address - City:APPLETON
Practice Address - State:WI
Practice Address - Zip Code:54914-3012
Practice Address - Country:US
Practice Address - Phone:920-428-9190
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4310-012111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor