Individual
MR. JACKIE DAVID RICHMOND
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OPTICIAN
Contact information
Practice address
3010 MIDWESTERN PARKWAY, WICHITA FALLS, TX 76308-2835
(940) 692-3754
Mailing address
3010 MIDWESTERN PARKWAY, WICHITA FALLS, TX 76308-2835
(940) 692-3754
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
—
—
Other
Enumeration date
05/23/2007
Last updated
09/01/2011
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