Individual
MR. JASON N RICHARDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OT
Contact information
Practice address
2200 FORT JESSE RD, NORMAL, IL 61761-6286
(309) 888-9800
(866) 888-9198
Mailing address
2200 FORT JESSE RD, NORMAL, IL 61761-6286
(309) 888-9800
(866) 888-9198
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
056.007160
IL
Other
Enumeration date
08/06/2012
Last updated
08/06/2012
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