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Individual

RICHARD CHARLES LANDON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MSPT

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
J1-0002838
DE
225100000X
Physical Therapist
PT015816
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
LA1413014
BCBS
PA
01
P01089025
MEDICARE RAILROAD
PA
Enumeration date
09/20/2005
Last updated
11/21/2012
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