Individual
SELWYN RICHARDSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
125 BUENA VISTA CIR, SOUTH HILL, VA 23970-1431
(401) 241-7549
Mailing address
237 RIDGE RD, HENDERSON, NC 27536-5930
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2306603226
VA
Other
Enumeration date
01/14/2013
Last updated
01/14/2013
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