Individual
JONATHAN NICHOLAS RICHARDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OTR/L
Contact information
Practice address
2865 E MAIN ST, HUMBOLDT, TN 38343-3070
(731) 784-8405
Mailing address
58 SADDLE TREE DR, HUMBOLDT, TN 38343-6706
(731) 439-6534
Taxonomy
Speciality
Code
Description
License number
State
225XG0600X
Gerontology Occupational Therapist
Primary
8092
TN
Other
Enumeration date
08/15/2024
Last updated
08/15/2024
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