Individual
REGGIE RICHARDSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
105 FOXGLOVE LN, IRMO, SC 29063-8394
(839) 205-6084
Mailing address
105 FOXGLOVE LN, IRMO, SC 29063-8394
(839) 205-6084
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
—
Other
Enumeration date
09/22/2025
Last updated
09/22/2025
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