Fried, Richard Gary
Fried, Richard Gary is an sole proprietor health care provider with primary practice located at 1715 5Th Ave , Moline IL 61265-7911. He recently has only one registered license in Chiropractic Providers / Chiropractor, which is considered as his primary health care specialty. Fried, Richard Gary can be contacted via phone (309) 762-1050.Contact Information
Primary practice address
1715 5Th Ave
Moline IL 61265-7911
Phone: (309) 762-1050
Fax: (309) 762-1064
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Chiropractic Providers / Chiropractor | 111N00000X | 038005386 | Illinois |
Profile Details
| NPI number | 1710984174 |
|---|---|
| LBN Legal business name | Fried, Richard Gary |
| Credentials | Doctor of Chiropractic (DC) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jun 30th, 2005 |
| Last updated | Oct 23rd, 2023 - about last year |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1710984174 | NPPES |
| Illinois | MEDICAID | 038005386 |
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