# BRANDON RICHARD

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1700650207
- **Gender:** Man
- **Credential:** PT, DPT, CSCS, KTCC

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225100000X | Physical Therapist | 12199R | LA | Yes |
| 225100000X | Physical Therapist | 1400726 | TX | — |
| 225100000X | Physical Therapist | LPT-034054 | AZ | — |
| 225100000X | Physical Therapist | PT41043 | FL | — |

## Other

- **Enumeration date:** 11/14/2023
- **Last updated:** 11/11/2025