Provider Demographics
NPI:1427883297
Name:RICHARDSON, JOSHUA CALEB (ATC)
Entity type:Individual
Prefix:
First Name:JOSHUA
Middle Name:CALEB
Last Name:RICHARDSON
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:537 E NORTHVIEW AVE APT 6
Mailing Address - Street 2:
Mailing Address - City:MCPHERSON
Mailing Address - State:KS
Mailing Address - Zip Code:67460-1946
Mailing Address - Country:US
Mailing Address - Phone:310-912-0921
Mailing Address - Fax:
Practice Address - Street 1:1600 E EUCLID ST
Practice Address - Street 2:
Practice Address - City:MCPHERSON
Practice Address - State:KS
Practice Address - Zip Code:67460-3847
Practice Address - Country:US
Practice Address - Phone:800-365-7402
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-03
Last Update Date:2024-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer