MEDICARE: PATRICK FRANCIS RICHARDSON DPT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	2305213910	VA

General Provider Information

NPI Number	:	1336743251
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PATRICK FRANCIS RICHARDSON DPT

Provider Business Mailing Address
First Line	:	2509 LEMMING CT
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23456-8007
Country	:	US
Telephone Number	:	701-876-9506
Fax Number	:

Provider Business Practice Location Address
First Line	:	1745 CAMELOT DR STE 100
Second Line	:
City	:	VIRGINIA BCH
State	:	VA
Zip	:	23454-2435
Country	:	US
Telephone Number	:	757-961-4800
Fax Number	:	757-961-0233

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/23/2020
Last Update Date	:	04/22/2022

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