Individual
TANNER RICHBERG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MS, CSCS, CEP
Contact information
Practice address
9051 PALMETTO COMMERCE PKWY, LADSON, SC 29456-6705
(843) 695-2205
Mailing address
214 GRACELAND DR, MONCKS CORNER, SC 29461-2516
(843) 531-2957
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
1065725
SC
Other
Enumeration date
02/22/2022
Last updated
02/22/2022
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