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NPI Code Detail

MEDICARE: RAEGAN M'KENZIE RICHEY

MEDICARE:   RAEGAN M'KENZIE RICHEY
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
1225200000XPhysical Therapy AssistantA7613NC

General Provider Information

NPI Number : 1548931306
Entity Type Code : Individual
Provider Name (Legal Business Name) : RAEGAN M'KENZIE RICHEY
Provider Business Mailing Address
First Line : PO BOX 667
Second Line :
City : NORTONVILLE
State : KY
Zip : 42442-0667
Country : US
Telephone Number : 270-871-8682
Fax Number :
Provider Business Practice Location Address
First Line : 213 WATER ST
Second Line :
City : DAWSON SPRINGS
State : KY
Zip : 42408-1727
Country : US
Telephone Number : 270-797-2025
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/22/2021
Last Update Date : 09/22/2021

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Directions to “ RAEGAN M'KENZIE RICHEY ” Practice Location

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