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Dr. Michael R Wild, DC
Chiropractor in Richmond, Virginia
NPI 1477623858

Michael R Wild is a Chiropractor based in Richmond, VA. Michael R Wild practices in Richmond, VA and has the professional credentials of DC. The NPI Number for Michael R Wild is 1477623858 and holds a License No. 0104001090 (Virginia).

The current practice location address for Michael R Wild is 3460 Lauderdale Dr, Richmond, VA and can be reached out via phone at 804-360-2273 and via fax at 804-360-7996.

Location: 3460 Lauderdale Dr, Richmond, VA, 23233-7529
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1477623858
Provider Name
Michael R Wild
Credential
DC
Provider Entity Type
Individual
Gender
Male
Address
3460 Lauderdale Dr, Richmond, VA, 23233-7529
Phone Number
804-360-2273
Fax Number
804-360-7996
Provider Enumeration Date
11/09/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
54 1910925 01 VA TAX ID
181767 01 VA BCBS
institution
Provider Business Practice Location Address Details
Address
3460 Lauderdale Dr
City
Richmond
State
Virginia
Zip
23233-7529
Phone Number
804-360-2273
Fax Number
804-360-7996
person
Provider Business Mailing Address Details
Address
3460 Lauderdale Dr
City
Richmond
State
Virginia
Zip
23233-7529
Phone Number
804-360-2273
Fax Number
804-360-7996
person
Provider's Taxonomy Details 1
Type
Chiropractic Providers
Classification
Chiropractor
Speciality
-
Taxonomy
111N00000X
License No.
0104001090 (Virginia)
Definition
A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems.
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