Individual
KIM RICHARDSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2800 PEOPLES ST STE 90, JOHNSON CITY, TN 37604-4158
(423) 928-0345
Mailing address
218 KEEFAUVER RD, JOHNSON CITY, TN 37615-4409
(423) 676-5863
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
3764
TN
Other
Enumeration date
03/30/2022
Last updated
03/30/2022
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