Individual
KIMBERLY RUTH RICHARDSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1012 E CHERRY ST, ALTUS, OK 73521-6402
(580) 471-6332
Mailing address
1012 E CHERRY ST, ALTUS, OK 73521-6402
(580) 471-6332
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
11/24/2014
Last updated
11/24/2014
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