Individual
JAMIE L RICHARDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
4560 SE INTERNATIONAL WAY STE 100, MILWAUKIE, OR 97222-4628
(563) 340-5531
Mailing address
5125 TAYLOR ST, DAVENPORT, IA 52806-3756
(563) 340-5531
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
077601
IA
Other
Enumeration date
05/24/2024
Last updated
05/24/2024
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