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General NPI Number Information
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NPI Number | 1922262716
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Entity Type | Individual
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Provider Name | JULIE RENAE RICHARDSON P.T.
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Gender | Female
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Dates
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Enumeration Date | 07/11/2008
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Last Update Date | 12/16/2025
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Provider Practice Location Address
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Address Line | 225 S M 37 HWY
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City | HASTINGS
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State | MI
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Zip | 49058-9676
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Country | US
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Telephone | 616-333-2721
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Fax | 616-719-1932
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Provider Business Mailing Address
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Address Line | 2020 RAYBROOK ST SE STE 101
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City | GRAND RAPIDS
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State | MI
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Zip | 49546-7717
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Country | US
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Telephone | 616-333-2721
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Fax | 616-719-1932
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 5501004770
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License Number State | MI
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