Provider Demographics
NPI:1336380096
Name:RICHARDSON, CATHY LEE (PT)
Entity Type:Individual
Prefix:
First Name:CATHY
Middle Name:LEE
Last Name:RICHARDSON
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:756 RIDGE LAKE BLVD
Mailing Address - Street 2:SUITE 205
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38120-9420
Mailing Address - Country:US
Mailing Address - Phone:901-767-3667
Mailing Address - Fax:901-767-3669
Practice Address - Street 1:756 RIDGE LAKE BLVD
Practice Address - Street 2:SUITE 205
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38120-9420
Practice Address - Country:US
Practice Address - Phone:901-767-3667
Practice Address - Fax:901-767-3669
Is Sole Proprietor?:No
Enumeration Date:2009-03-10
Last Update Date:2009-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1851225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist