Organization
ORTHOPEDIC & SPINE SURGERY CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TRAVIS DALE RICHARDSON D.O. (OWNER)
(870) 239-8163
Entity
Organization
Contact information
Practice address
1507 LINWOOD DR, PARAGOULD, AR 72450
(815) 993-6699
(870) 239-8105
Mailing address
1507 LINWOOD DR STE B, PARAGOULD, AR 72450-5818
(870) 239-8164
(870) 239-8105
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Enumeration date
04/04/2017
Last updated
04/30/2020
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