Individual
MARY LEE RICHARDSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1591 GLENN PL SW, MABLETON, GA 30126-1170
(216) 702-7316
Mailing address
1591 GLENN PL SW, MABLETON, GA 30126-1170
(216) 702-7316
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
GA
Other
Enumeration date
10/25/2020
Last updated
10/25/2020
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