Provider Demographics
NPI:1336743251
Name:RICHARDSON, PATRICK FRANCIS (DPT)
Entity Type:Individual
Prefix:
First Name:PATRICK
Middle Name:FRANCIS
Last Name:RICHARDSON
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2509 LEMMING CT
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23456-8007
Mailing Address - Country:US
Mailing Address - Phone:701-876-9506
Mailing Address - Fax:
Practice Address - Street 1:1745 CAMELOT DR STE 100
Practice Address - Street 2:
Practice Address - City:VIRGINIA BCH
Practice Address - State:VA
Practice Address - Zip Code:23454-2435
Practice Address - Country:US
Practice Address - Phone:757-961-4800
Practice Address - Fax:757-961-0233
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-23
Last Update Date:2022-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305213910225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist