Organization
RICHARDSON PROSTHETICS & ORTHOTICS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RONDELL RICHARDSON CO, BOCP (OWNER)
(704) 510-2204
Entity
Organization
Contact information
Practice address
3210 PROSPERITY CHURCH RD STE 101, CHARLOTTE, NC 28269-8194
(704) 510-2204
Mailing address
3210 PROSPERITY CHURCH RD STE 101, CHARLOTTE, NC 28269-8194
(704) 510-2204
(704) 510-2218
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
—
—
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
157863421
—
NC
Enumeration date
07/07/2020
Last updated
04/29/2026
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