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General NPI Number Information
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NPI Number | 1578701637
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Entity Type | Individual
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Provider Name | BETH E RICHARDSON DPT
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Gender | Female
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Dates
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Enumeration Date | 01/28/2009
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Last Update Date | 03/12/2025
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Provider Practice Location Address
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Address Line | 45445 MOUND RD STE 109
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City | SHELBY TOWNSHIP
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State | MI
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Zip | 48317-5178
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Country | US
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Telephone | 248-297-0991
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Fax |
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Provider Business Mailing Address
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Address Line | 42 AUDUBON ROAD
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City | OXFORD
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State | MI
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Zip | 48370-2452
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Country | US
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Telephone | 248-909-2929
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | 5501012963
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 550102963
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License Number State | MI
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