Amy Richardson

Individual provider Active NPI Physical Therapy Assistant · Axton, VA

NPI 1861801045 · NPPES record last updated Aug 12, 2014

Key facts

NPI
1861801045
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapy Assistant 225200000X
License
2306603832 (VA)
Practice address
113 Linnies CT
Axton, VA 24054-1729
Phone
(276) 806-6144
NPI assigned
Aug 12, 2014
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
2306603832VAMDPhysical Therapy Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 2306603832 VA Yes

Addresses

Primary practice location

113 Linnies CT
Axton, VA 24054-1729

Mailing address

113 Linnies CT
Axton, VA 24054-1729
Phone (276) 806-6144

Other providers in Axton, VA

All providers in Axton, VA · Physical Therapy Assistant in Virginia

Sources for this page

Verify at the official NPI Registry.