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1013663764
TANNER RICHBERG
LADSON, SC
NPI
1013663764
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: SC 1065725)
Enumeration Date
2022-02-22
Last Update Date
2022-02-22
Business Address
TANNER RICHBERG MS, CSCS, CEP
9051 PALMETTO COMMERCE PKWY
LADSON, SC 29456-6705
Phone number: 843-695-2205
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Mailing Address
TANNER RICHBERG MS, CSCS, CEP
214 GRACELAND DR
MONCKS CORNER, SC 29461-2516
Phone number: 843-531-2957
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