Provider Demographics
NPI:1518218148
Name:RICHARDSON, HUNTER SETH (PT)
Entity type:Individual
Prefix:
First Name:HUNTER
Middle Name:SETH
Last Name:RICHARDSON
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4900 OKLAHOMA AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:WOODWARD
Mailing Address - State:OK
Mailing Address - Zip Code:73801-3719
Mailing Address - Country:US
Mailing Address - Phone:580-377-3670
Mailing Address - Fax:580-701-2466
Practice Address - Street 1:4900 OKLAHOMA AVE STE 200
Practice Address - Street 2:
Practice Address - City:WOODWARD
Practice Address - State:OK
Practice Address - Zip Code:73801-3719
Practice Address - Country:US
Practice Address - Phone:580-377-3670
Practice Address - Fax:580-701-2466
Is Sole Proprietor?:No
Enumeration Date:2012-09-22
Last Update Date:2024-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK4612225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist