Individual
ANTOINE CHARLES RICHARDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1900 GLENDON AVE APT 102, LOS ANGELES, CA 90025-4627
(310) 906-5112
Mailing address
1900 GLENDON AVE APT 102, LOS ANGELES, CA 90025-4627
(310) 906-5112
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
57181
CA
Other
Enumeration date
08/14/2020
Last updated
08/14/2020
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