Provider Demographics
NPI:1881747483
Name:MARQUARDT, RICHARD
Entity type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:
Last Name:MARQUARDT
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 1:442 WREN TRL NW
Mailing Address - Street 2:
Mailing Address - City:BARKUS
Mailing Address - State:MN
Mailing Address - Zip Code:56435
Mailing Address - Country:US
Mailing Address - Phone:218-947-3322
Mailing Address - Fax:
Practice Address - Street 1:UPPER MISSISSIPPI MENTAL HEALTH CENTER
Practice Address - Street 2:120 N MAIN STREET
Practice Address - City:PARK RAPIDS
Practice Address - State:MN
Practice Address - Zip Code:56470
Practice Address - Country:US
Practice Address - Phone:218-732-7266
Practice Address - Fax:218-732-0136
Is Sole Proprietor?:No
Enumeration Date:2007-01-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner