Provider Demographics
NPI:1760080725
Name:RICHARDS, HUNTER BROOKE
Entity Type:Individual
Prefix:MISS
First Name:HUNTER
Middle Name:BROOKE
Last Name:RICHARDS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1669 MAUMEE DR
Mailing Address - Street 2:
Mailing Address - City:XENIA
Mailing Address - State:OH
Mailing Address - Zip Code:45385-4216
Mailing Address - Country:US
Mailing Address - Phone:937-238-9168
Mailing Address - Fax:
Practice Address - Street 1:1669 MAUMEE DR
Practice Address - Street 2:
Practice Address - City:XENIA
Practice Address - State:OH
Practice Address - Zip Code:45385-4216
Practice Address - Country:US
Practice Address - Phone:937-238-9168
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-13
Last Update Date:2020-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251X00000XAgenciesSupports Brokerage