Healthcare Provider Details

I. General information

NPI: 1083171094
Provider Name (Legal Business Name): AMY RICHMOND DC, DAT, LAT, ATC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/26/2019
Last Update Date: 01/13/2026
Certification Date: 01/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17060 N THOMPSON PEAK PKWY STE 100
SCOTTSDALE AZ
85255-2558
US

IV. Provider business mailing address

7215 E SILVERSTONE DR APT 3106
SCOTTSDALE AZ
85255-4972
US

V. Phone/Fax

Practice location:
  • Phone: 609-970-1382
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License NumberATR-100156
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License NumberRT005583
License Number StatePA
# 3
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number9409
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: