Individual
MR. RICHARD JOHN WALDRON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
1099 D STREET SUITE 105, SAN RAFAEL, CA 94901-2839
(415) 532-8395
Mailing address
257 ETHEL AVE, MILL VALLEY, CA 94941-2731
(415) 302-0456
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
PT15104
CA
2251X0800X
Orthopedic Physical Therapist
Primary
PT15104
CA
Other
Enumeration date
11/30/2005
Last updated
09/07/2012
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