Individual
LARRY RICHARDSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2866 EMPIRE AVE, LOVELAND, CO 80538-3001
(970) 613-0726
Mailing address
PO BOX 2122, LOVELAND, CO 80539-2122
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
12538361
—
CO
Enumeration date
07/25/2016
Last updated
07/25/2016
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