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CHRIS DWIGHT RICHARDSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PTA

Contact information

Practice address
#6 CTY RD 5149, BLOOMFIELD, NM 87413
(505) 215-6614
Mailing address
#6 CTY RD. 5149, BLOOMFIELD, NM 87413
(505) 215-6613

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
A-0554
NM

Other

Enumeration date
10/05/2009
Last updated
10/05/2009
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