Dustin Richert, PT Valid NPI

Individual provider · Physical Therapist · O Fallon, IL

NPI

1063779403

Type

Individual (Type 1)

Primary specialty

Physical Therapist

Specialty group

Respiratory, Developmental, Rehabilitative and Restorative Service Providers

Taxonomy code

225100000X

License number

070.016295 (IL)

Sex

Male

Sole proprietor

No

Enumerated

2012-04-23

Last updated

2012-04-23