Individual
DEVAN RICHARDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
2633 TRACELAND DR, TUPELO, MS 38801-4238
(662) 554-9699
Mailing address
2633 TRACELAND DR, TUPELO, MS 38801-4238
(662) 554-9699
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT6740
MS
Other
Enumeration date
10/17/2019
Last updated
10/17/2019
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