Provider Demographics
NPI:1750364220
Name:RESER, RICHARD E (DC)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:E
Last Name:RESER
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 1:14 W MARKET ST
Mailing Address - Street 2:
Mailing Address - City:TIFFIN
Mailing Address - State:OH
Mailing Address - Zip Code:44883-2720
Mailing Address - Country:US
Mailing Address - Phone:419-447-3343
Mailing Address - Fax:419-447-3436
Practice Address - Street 1:14 W MARKET ST
Practice Address - Street 2:
Practice Address - City:TIFFIN
Practice Address - State:OH
Practice Address - Zip Code:44883-2720
Practice Address - Country:US
Practice Address - Phone:419-447-3343
Practice Address - Fax:419-447-3436
Is Sole Proprietor?:No
Enumeration Date:2005-11-29
Last Update Date:2024-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2328111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0229505Medicaid
OH0229505Medicaid
U60605Medicare UPIN