Doctor Name: | GLENN L. RICHARDSON |
NPI Number: | 1326032392 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PT |
License Number: | LA 03589 |
Business Practice Address: | 160 Christian Dr Box 834 Rayville, LA - 712693645 |
Business Phone Number: | 3187284088 |
Business Fax Number: | 3187284124 |
Mailing Address: | 950 Highway 584, RAYVILLE |
State: | LA |
Postal Code: | 712694328 |
Phone Number: | 3187288879 |
Fax Number: | 3187288879 |
NPI Enumeration Date: | 09/07/2005 |
NPI Last Update Date: | 02/17/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | LA 03589 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | LA |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Physical Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |