Provider Demographics
NPI:1750585527
Name:RICHARDS, CHUCK LEE (DPT)
Entity type:Individual
Prefix:
First Name:CHUCK
Middle Name:LEE
Last Name:RICHARDS
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 1:121 N 20TH ST STE 18
Mailing Address - Street 2:P.O. BOX 2125
Mailing Address - City:OPELIKA
Mailing Address - State:AL
Mailing Address - Zip Code:36801-5457
Mailing Address - Country:US
Mailing Address - Phone:334-364-2241
Mailing Address - Fax:334-364-2251
Practice Address - Street 1:121 N 20TH ST STE 18
Practice Address - Street 2:
Practice Address - City:OPELIKA
Practice Address - State:AL
Practice Address - Zip Code:36801-5457
Practice Address - Country:US
Practice Address - Phone:334-364-2241
Practice Address - Fax:334-364-2251
Is Sole Proprietor?:No
Enumeration Date:2007-06-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL237382251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic