Provider Demographics
NPI:1831581305
Name:RICHARDSON, AMBER LEANN (PT, DPT)
Entity type:Individual
Prefix:MRS
First Name:AMBER
Middle Name:LEANN
Last Name:RICHARDSON
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:489 HIGHWAY 7 N
Mailing Address - Street 2:
Mailing Address - City:WHITESBURG
Mailing Address - State:KY
Mailing Address - Zip Code:41858-8249
Mailing Address - Country:US
Mailing Address - Phone:606-633-3500
Mailing Address - Fax:606-633-3627
Practice Address - Street 1:240 HOSPITAL RD
Practice Address - Street 2:
Practice Address - City:WHITESBURG
Practice Address - State:KY
Practice Address - Zip Code:41858-7627
Practice Address - Country:US
Practice Address - Phone:606-633-3500
Practice Address - Fax:606-633-3627
Is Sole Proprietor?:No
Enumeration Date:2015-02-20
Last Update Date:2015-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY005920225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist