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NPI Code Detail

MEDICARE: MRS. ADRIANNA ROSE RICHARDSON

MEDICARE: MRS. ADRIANNA ROSE RICHARDSON
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 AssistantA04123KY

General Provider Information

NPI Number : 1649848052
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. ADRIANNA ROSE RICHARDSON
Provider Business Mailing Address
First Line : 814 S FRANKLIN ST
Second Line :
City : MADISONVILLE
State : KY
Zip : 42431-2943
Country : US
Telephone Number : 270-836-8918
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 : 06/12/2021
Last Update Date : 06/12/2021

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