Individual
MARCUS ANTIONE RICHARDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LAT, ATC, CPT
Contact information
Practice address
3992 CENTRAL CAMPUS DRIVE DEPT 3504, OGDEN, UT 84408-7640
(801) 626-7656
Mailing address
1598 SAWMILL CREEK LN, CORDOVA, TN 38016-7640
(901) 244-0643
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
246RP1900X
Phlebotomy Technician
—
—
Other
Enumeration date
09/26/2022
Last updated
06/10/2024
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