Individual
DR. BRADLEY D RICHTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
1965 11TH AVE E, MAPLEWOOD, MN 55109-5167
(651) 777-3555
(651) 777-4459
Mailing address
1965 11TH AVE E, MAPLEWOOD, MN 55109-5167
(651) 777-3555
(651) 777-4459
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1960
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
410012529
RAILROAD MEDICARE
MN
05
—
537723400
—
MN
Enumeration date
05/10/2006
Last updated
02/15/2008
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