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NPI Code Detail

MEDICARE: DR. RICHARD NEIL WETHERALD PT

MEDICARE: DR. RICHARD NEIL WETHERALD PT
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
1225100000XPhysical TherapistPT297427CA

General Provider Information

NPI Number : 1871925289
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. RICHARD NEIL WETHERALD PT
Provider Business Mailing Address
First Line : 3400 CALLOWAY DR STE 603
Second Line :
City : BAKERSFIELD
State : CA
Zip : 93312-2514
Country : US
Telephone Number : 661-377-1700
Fax Number : 661-616-9199
Provider Business Practice Location Address
First Line : 7900 DISTRICT BLVD UNIT A
Second Line :
City : BAKERSFIELD
State : CA
Zip : 93313-4845
Country : US
Telephone Number : 661-377-1700
Fax Number : 661-616-9199
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/07/2013
Last Update Date : 01/16/2020

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