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NPI Code Detail

MEDICARE: JAMES RICHARD STRADER

MEDICARE:   JAMES RICHARD STRADER
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12255R0406XBlind Rehabilitation Specialist/Technologist6216

General Provider Information

NPI Number : 1518504679
Entity Type Code : Individual
Provider Name (Legal Business Name) : JAMES RICHARD STRADER
Provider Business Mailing Address
First Line : 810 MAPLE ST
Second Line :
City : ALEXANDRIA
State : MN
Zip : 56308-1926
Country : US
Telephone Number : 314-809-8673
Fax Number :
Provider Business Practice Location Address
First Line : 810 MAPLE ST
Second Line :
City : ALEXANDRIA
State : MN
Zip : 56308-1926
Country : US
Telephone Number : 314-809-8673
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/06/2019
Last Update Date : 12/06/2019

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Directions to “ JAMES RICHARD STRADER ” Practice Location

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