Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251N0400X | Physical Therapist - Neurology | 2007022413 | MO |
NPI | 1104139252 |
---|---|
Provider Name | Mrs. Leah Michelle Richter |
First Address | Springfield, MO 65807-7310 |
Second Address | Springfield, MO 65807-7310 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/07/2010 |
Last Update Date | 07/05/2020 |