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General NPI Number Information
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NPI Number | 1871754101
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Entity Type | Individual
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Provider Name | TRACY L RICHARDSON LMT
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Gender | Female
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Dates
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Enumeration Date | 06/19/2008
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Last Update Date | 01/19/2010
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Provider Practice Location Address
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Address Line | 1101 W MOANA LN
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City | RENO
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State | NV
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Zip | 89509-4775
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Country | US
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Telephone | 775-338-5353
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Fax |
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Provider Business Mailing Address
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Address Line | 2700 PLUMAS ST #321
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City | RENO
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State | NV
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Zip | 89509-4159
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Country | US
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Telephone | 775-338-5353
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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 | 172M00000X
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Taxonomy Name | Mechanotherapist
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License Number | 4007
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License Number State | NV
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