Provider Demographics
NPI:1740335736
Name:SALAS, RICHARD O
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:O
Last Name:SALAS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6324 N SPALDING AVE
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93710-5724
Mailing Address - Country:US
Mailing Address - Phone:559-436-4742
Mailing Address - Fax:
Practice Address - Street 1:2171 N FINE AVE
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93727-1519
Practice Address - Country:US
Practice Address - Phone:559-455-2040
Practice Address - Fax:559-455-2041
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner