Provider Demographics
NPI:1043073190
Name:RICKARD, JO
Entity type:Individual
Prefix:
First Name:JO
Middle Name:
Last Name:RICKARD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2547 ANGEL CT
Mailing Address - Street 2:
Mailing Address - City:GULF BREEZE
Mailing Address - State:FL
Mailing Address - Zip Code:32563-5552
Mailing Address - Country:US
Mailing Address - Phone:850-741-6715
Mailing Address - Fax:850-204-0489
Practice Address - Street 1:7830 PINE FOREST RD # COTTAGEA
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32526-8404
Practice Address - Country:US
Practice Address - Phone:850-741-6715
Practice Address - Fax:850-204-0489
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-01
Last Update Date:2024-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist