Individual
MISS PEGGY RICHARDS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
299 W BRONX RD UNIT A, SANDPOINT, ID 83864-9505
(208) 263-7270
Mailing address
217 CEDAR ST # 271, SANDPOINT, ID 83864-1410
(208) 263-7270
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MT-04668P
AZ
Other
Enumeration date
02/11/2008
Last updated
02/11/2008
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