Provider Demographics
NPI:1952503294
Name:MCLAUGHLIN, RICHARD THOMAS (PT)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:THOMAS
Last Name:MCLAUGHLIN
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:651 CHESTNUT ST
Mailing Address - Street 2:
Mailing Address - City:RICHLAND CENTER
Mailing Address - State:WI
Mailing Address - Zip Code:53581-1507
Mailing Address - Country:US
Mailing Address - Phone:608-475-1363
Mailing Address - Fax:608-649-1363
Practice Address - Street 1:651 CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:RICHLAND CENTER
Practice Address - State:WI
Practice Address - Zip Code:53581-1507
Practice Address - Country:US
Practice Address - Phone:608-475-1363
Practice Address - Fax:608-649-1363
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-31
Last Update Date:2011-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI5094-024225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist