Provider Demographics
NPI:1215999792
Name:TODD, RICHARD HEATH (MPT)
Entity type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:HEATH
Last Name:TODD
Suffix:
Gender:M
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 TAMSEN LANE
Mailing Address - Street 2:PO BOX 233
Mailing Address - City:FORT MONTGOMERY
Mailing Address - State:NY
Mailing Address - Zip Code:10922
Mailing Address - Country:US
Mailing Address - Phone:845-938-3324
Mailing Address - Fax:
Practice Address - Street 1:KELLER ARMY COMMUNITY HOSPITAL
Practice Address - Street 2:BLD 900
Practice Address - City:WEST POINT
Practice Address - State:NY
Practice Address - Zip Code:10996
Practice Address - Country:US
Practice Address - Phone:845-938-3324
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT016202225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist