Individual
MARILYN J RICHARDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
600 EAST 7TH ST., LOWRY CITY, MO 64763
(417) 298-5263
Mailing address
RR 1 BOX 40-30, WEAUBLEAU, MO 65774-9510
(417) 298-5263
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2010029437
MO
Other
Enumeration date
07/20/2012
Last updated
07/20/2012
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