| Doctor Name: | MR. RICHARD JOHN WALDRON |
| NPI Number: | 1962486464 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PT |
| License Number: | PT15104 |
| Business Practice Address: | 1099 D Street Suite 105 San Rafael, CA - 949012839 |
| Business Phone Number: | 4155328395 |
| Business Fax Number: | |
| Mailing Address: | 257 Ethel Ave, MILL VALLEY |
| State: | CA |
| Postal Code: | 949412731 |
| Phone Number: | 4153020456 |
| Fax Number: | |
| NPI Enumeration Date: | 11/30/2005 |
| NPI Last Update Date: | 09/07/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | PT15104 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | CA |
| 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 |