Individual
WILLIAM DEREK RICHARDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
821 N NELLIS BLVD STE 130, LAS VEGAS, NV 89110-5387
(702) 452-4563
Mailing address
3924 MINEOLA WAY, NORTH LAS VEGAS, NV 89032-0465
(702) 251-8477
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1177
LICENSE #
NE
Enumeration date
08/29/2006
Last updated
07/08/2007
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