Provider Demographics
NPI:1417078445
Name:RICHTERS, MISTY MARIE
Entity Type:Individual
Prefix:
First Name:MISTY
Middle Name:MARIE
Last Name:RICHTERS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:SOUTHWESTERN CASE
Other - Middle Name:MANAGEMENT
Other - Last Name:LLC
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:1604 E SPRUCE ST
Mailing Address - Street 2:
Mailing Address - City:GARDEN CITY
Mailing Address - State:KS
Mailing Address - Zip Code:67846-6326
Mailing Address - Country:US
Mailing Address - Phone:620-275-6298
Mailing Address - Fax:620-275-0600
Practice Address - Street 1:1604 E SPRUCE ST
Practice Address - Street 2:
Practice Address - City:GARDEN CITY
Practice Address - State:KS
Practice Address - Zip Code:67846-6326
Practice Address - Country:US
Practice Address - Phone:620-275-6298
Practice Address - Fax:620-275-0600
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management