Individual
MR. DAVID RICHARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BSN, RN
Contact information
Practice address
516 E NIZHONI BLVD, GALLUP, NM 87301-5748
(505) 722-1000
Mailing address
309 ROOSEVELT ST, JOHNSON CITY, TN 37601-2843
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
187590
TN
Other
Enumeration date
03/13/2013
Last updated
03/13/2013
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