Individual
JEFFREY S RICHARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
433 N CAPITOL AVE, STE 102, INDIANAPOLIS, IN 46204-1234
(317) 860-1646
(317) 636-2207
Mailing address
790 REMINGTON BLVD, BOLINGBROOK, IL 60440-4909
(630) 296-2223
(630) 759-9510
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
05011164A
IN
Other
Enumeration date
06/24/2013
Last updated
11/05/2014
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