Jesse Wayne Richardson, MSPT
NPI #1801889860 in Randolph a F B, Texas
Provider Information
- NPI Number
- 1801889860
- Entity Type
- Individual
- Name
- Jesse Wayne Richardson, MSPT
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Specialist
- Credential
- MSPT
- Enumeration Date
- Aug 25, 2005
- Last Updated
- Jan 13, 2014
Practice Location
- Address
- 221 3RD ST W
- Address 2
- BLDG 1040
- City
- Randolph a F B
- State
- Texas
- ZIP Code
- 78150-4800
- Phone
- (210) 652-3137
Specialties & Taxonomy Codes
| Specialty |
|---|
| Specialist |
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