Most Relevant Information
Provider Data
| NPI Number: | 1003670266 |
| Provider Name: | JORDYN RICHARDSON ATC, LAT |
| Entity Type: | Individual |
| Taxonomy Code: | 2255A2300X |
| Specialty: | Specialist/Technologist |
| License Number: | AT7834 |
Most Important Dates
| Enumeration Date: | 02/08/2024 |
| Last Updated: | 02/08/2024 |
Provider Practice Location
3133 GOOD SHEPHERD WAY
LONGVIEW
TX
756057921
Practice Location Phone/Fax
| Phone: | 9033236500 |
| Fax: |
Provider Mailing Location
1136 MISSION CREEK DR
LONGVIEW
TX
756018610
Provider Mailing Phone/Fax
| Phone: | 9099572353 |
| Fax: |