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General NPI Number Information
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NPI Number | 1609354034
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Entity Type | Organization
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Legal Business Name | JOHANNA M RICHEY, DPM, PC
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Dates
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Enumeration Date | 07/28/2018
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Last Update Date | 04/16/2019
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Provider Practice Location Address
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Address Line | 2741 S 8TH AVE STE A
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City | YUMA
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State | AZ
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Zip | 85364-7154
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Country | US
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Telephone | 928-726-6295
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Fax |
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Provider Business Mailing Address
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Address Line | 2091 W 25TH ST
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City | YUMA
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State | AZ
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Zip | 85364-6911
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Country | US
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Telephone | 928-276-6271
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Fax | 928-276-4730
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Authorized Official
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Title or Position | OWNER
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Name | JOHANNA MARIE RICHEY
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Credential | DPM
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Telephone | 602-432-1274
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | 883
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License Number State | AZ
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