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Individual

BRANDON RICHARDSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PT

Contact information

Practice address
2080 44TH ST SE STE 150, GRAND RAPIDS, MI 49508-5299
(616) 233-3590
Mailing address
607 DEWEY AVE NW STE 300, GRAND RAPIDS, MI 49504-5283
(616) 356-5000
(616) 356-5001

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5501019689
MI

Other

Enumeration date
11/17/2020
Last updated
11/17/2020
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