Tanner Richberg, MS, CSCS, CEP
Specialist/Technologist, Athletic Trainer in Ladson, SC. Individual provider (NPI-1).
NPI number1013663764
StatusActive
Last updated in NPPESFeb 22, 2022
Details
- NPI
- 1013663764
- Entity type
- Individual (NPI-1)
- Name
- Tanner Richberg
- Credential
- MS, CSCS, CEP
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Feb 22, 2022
- Certification date
- Feb 22, 2022
- Last updated
- Feb 22, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2255A2300X | Specialist/Technologist, Athletic Trainer | 1065725 | SC | Yes |
Practice location
9051 Palmetto Commerce PkwyLadson, SC 29456-6705
Phone 843-695-2205
Mailing address
214 Graceland DrMoncks Corner, SC 29461-2516
Phone 843-531-2957
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