Individual
BRANDON RICHARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT, DPT, CSCS, KTCC
Contact information
Practice address
6300 MAIN ST, ZACHARY, LA 70791-4037
(225) 658-6800
Mailing address
6300 MAIN ST, ZACHARY, LA 70791-4037
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
12199R
LA
225100000X
Physical Therapist
1400726
TX
225100000X
Physical Therapist
LPT-034054
AZ
225100000X
Physical Therapist
PT41043
FL
Other
Enumeration date
11/14/2023
Last updated
11/11/2025
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