Individual
COUNTESS-JAI RICHARDS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5285 LEWISTON RD, LEWISTON, NY 14092-1942
(716) 298-2900
Mailing address
67 EDGEBROOK EST APT 10, CHEEKTOWAGA, NY 14227-2005
(718) 249-9843
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
043917
NY
Other
Enumeration date
03/13/2019
Last updated
03/13/2019
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