Individual
TABANI RICHARDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
136 SPORTS CENTER DR, LEXINGTON, KY 40506-0227
(859) 257-8953
Mailing address
618 BIG BEAR LN, LEXINGTON, KY 40517-2054
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT983
KY
Other
Enumeration date
04/19/2014
Last updated
04/19/2014
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