Individual
MR. JOHN J RIESENBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
101 E WOOD ST, SPARTANBURG, SC 29303
(864) 560-6000
Mailing address
155 CRANSTON DR, CHESNEE, SC 29323-9068
(864) 541-8565
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
070502170
SC
2255A2300X
Athletic Trainer
843
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
070502170
NATA CERTIFICATION
SC
01
—
843
DHEC
SC
Enumeration date
04/12/2007
Last updated
09/15/2008
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