Healthcare Provider Details

I. General information

NPI: 1194823807
Provider Name (Legal Business Name): RICHARD CHARLES HUTCHINS PT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/20/2006
Last Update Date: 10/16/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

412 12TH AVE N
ST PETERSBURG FL
33701-1120
US

IV. Provider business mailing address

PO BOX 7746
ST PETERSBURG FL
33734-7746
US

V. Phone/Fax

Practice location:
  • Phone: 727-898-5001
  • Fax: 727-894-0554
Mailing address:
  • Phone: 727-898-5001
  • Fax: 727-894-0554

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT 1891
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: