Individual
CARLA BOELTE RICHARDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
VATL, ATC
Contact information
Practice address
572 GARRISONVILLE RD, STAFFORD, VA 22554-3702
(540) 659-6408
Mailing address
572 GARRISONVILLE RD, STAFFORD, VA 22554-3702
(540) 659-6408
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
0126001046
VA
Other
Enumeration date
05/25/2007
Last updated
12/18/2012
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