Individual
JERRY ALLEN RICHT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
76 MOUSE CREEK RD NW, CLEVELAND, TN 37312-4875
(423) 472-5085
(423) 476-7411
Mailing address
76 MOUSE CREEK RD NW, CLEVELAND, TN 37312-4875
(423) 472-5085
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
T884
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3595259
—
TN
Enumeration date
02/09/2007
Last updated
07/18/2024
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