| Doctor Name: | MR. JEFFREY MARK RICHARDS |
| NPI Number: | 1386832533 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PT |
| License Number: | PT-001173-E |
| Business Practice Address: | 601 Park St Honesdale, PA - 184311445 |
| Business Phone Number: | 5702538100 |
| Business Fax Number: | |
| Mailing Address: | 1420 Turkey Ridge Rd Unit D, SURFSIDE BEACH |
| State: | SC |
| Postal Code: | 295758233 |
| Phone Number: | 8143974050 |
| Fax Number: | |
| NPI Enumeration Date: | 10/11/2007 |
| NPI Last Update Date: | 10/11/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | PT-001173-E |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PA |
| 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 |