Individual
MR. RICHARD BRIAN STAUDT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OTR/L
Contact information
Practice address
1108 N CAMELOT DR, PAYSON, AZ 85541-3302
(928) 468-2333
Mailing address
1108 N CAMELOT DR, PAYSON, AZ 85541-3302
(928) 468-2333
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
0883
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
50033509
BLUE CROSS
PA
Enumeration date
07/22/2005
Last updated
10/28/2009
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