Basic Information
| Provider Information | |||||||||
| NPI: | 1336743251 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | RICHARDSON | ||||||||
| FirstName: | PATRICK | ||||||||
| MiddleName: | FRANCIS | ||||||||
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| Credential: | DPT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2509 LEMMING CT | ||||||||
| Address2: | |||||||||
| City: | VIRGINIA BEACH | ||||||||
| State: | VA | ||||||||
| PostalCode: | 234568007 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7018769506 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 1745 CAMELOT DR STE 100 | ||||||||
| Address2: | |||||||||
| City: | VIRGINIA BCH | ||||||||
| State: | VA | ||||||||
| PostalCode: | 234542435 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7579614800 | ||||||||
| FaxNumber: | 7579610233 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/23/2020 | ||||||||
| LastUpdateDate: | 04/22/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 04/22/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 2305213910 | VA | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.