Individual
MR. RICHARD MAHIEU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MED., ATC
Contact information
Practice address
1219 W SPRING ST, MONROE, GA 30655-1756
(770) 207-6624
Mailing address
1219 W SPRING ST, MONROE, GA 30655-1756
(770) 207-6624
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT002354
GA
Other
Enumeration date
04/18/2016
Last updated
04/18/2016
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