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Individual

DR. MATTHEW SCOT RICHARDSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
853 NE A ST, GRANTS PASS, OR 97526-2211
(541) 474-2788
(541) 474-0516
Mailing address
853 NE A ST, GRANTS PASS, OR 97526-2211
(541) 474-2788
(541) 474-0516

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2980ATI
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
276057
OR
01
2980ATI
STATE LICENSE
OR
Enumeration date
09/01/2006
Last updated
03/07/2023
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