Individual
JEFFREY D RICHARDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.T.
Contact information
Practice address
223 CIBEQUE CIRCLE ROAD, SAN CARLOS, AZ 85550-0208
(928) 475-7219
(928) 475-7370
Mailing address
PO BOX 208, SAN CARLOS, AZ 85550-0208
(928) 475-7219
(928) 475-7370
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5040 PT
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
482729
—
AZ
Enumeration date
08/31/2006
Last updated
07/09/2007
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