Provider Demographics
NPI:1477122307
Name:RICHARDSON, JOSHUA ALDWYN (DC)
Entity type:Individual
Prefix:DR
First Name:JOSHUA
Middle Name:ALDWYN
Last Name:RICHARDSON
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8400 113TH ST
Mailing Address - Street 2:
Mailing Address - City:SEMINOLE
Mailing Address - State:FL
Mailing Address - Zip Code:33772-4131
Mailing Address - Country:US
Mailing Address - Phone:727-201-4549
Mailing Address - Fax:866-265-0201
Practice Address - Street 1:8400 113TH ST
Practice Address - Street 2:
Practice Address - City:SEMINOLE
Practice Address - State:FL
Practice Address - Zip Code:33772-4131
Practice Address - Country:US
Practice Address - Phone:727-201-4549
Practice Address - Fax:866-265-0201
Is Sole Proprietor?:No
Enumeration Date:2021-06-24
Last Update Date:2021-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL13589111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor