Individual
BRYAN RIVERA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC, LAT
Contact information
Practice address
3175 SOUFFLE CT, ACWORTH, GA 30101-6232
(817) 851-6182
Mailing address
3175 SOUFFLE CT, ACWORTH, GA 30101-6232
(817) 851-6182
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT002516
GA
Other
Enumeration date
01/09/2015
Last updated
01/09/2015
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