Provider Demographics
NPI:1306425822
Name:RICHARDS, EILEEN (PT, DPT)
Entity type:Individual
Prefix:
First Name:EILEEN
Middle Name:
Last Name:RICHARDS
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:730 N MARIPOSA AVE APT 22
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90029-3448
Mailing Address - Country:US
Mailing Address - Phone:773-526-0239
Mailing Address - Fax:
Practice Address - Street 1:111 HUNTOON MEMORIAL HWY
Practice Address - Street 2:
Practice Address - City:ROCHDALE
Practice Address - State:MA
Practice Address - Zip Code:01542-1305
Practice Address - Country:US
Practice Address - Phone:508-892-4858
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-02
Last Update Date:2023-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty