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NPI Code Detail

MEDICARE: TESSA RICHARDSON

MEDICARE: TESSA RICHARDSON
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
1261QP2000XPhysical Therapy Clinic/Center10723MN

General Provider Information

NPI Number : 1821928029
Entity Type Code : Individual
Provider Name (Legal Business Name) : TESSA RICHARDSON
Provider Business Mailing Address
First Line : 19660 RINDE RD NW
Second Line :
City : PUPOSKY
State : MN
Zip : 56667-6851
Country : US
Telephone Number : 218-333-4745
Fax Number :
Provider Business Practice Location Address
First Line : 2017 NET WAY NW
Second Line :
City : BEMIDJI
State : MN
Zip : 56601-5147
Country : US
Telephone Number : 218-333-4745
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/20/2026
Last Update Date : 05/20/2026

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Directions to “ TESSA RICHARDSON ” Practice Location

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