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Individual

ALYSSE CORAVON RICHARDSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
D.C.

Contact information

Practice address
671 NW 119TH ST, MIAMI, FL 33168-2522
(305) 688-0811
Mailing address
671 NW 119TH ST, MIAMI, FL 33168-2522
(305) 688-0811

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CH 11040
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
020665100
FL
Enumeration date
01/27/2014
Last updated
12/11/2017
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