Individual
JOSEPH VAN RICHARDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3500 TOWER AVE, SUPERIOR, WI 54880-5335
(715) 817-7100
Mailing address
3500 TOWER AVE, SUPERIOR, WI 54880-5335
(715) 817-7100
Taxonomy
Speciality
Code
Description
License number
State
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
30866-020
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1316981327
—
WI
Enumeration date
06/16/2006
Last updated
01/14/2014
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