Individual
VICTORIA N RIEBOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, LAT, ATC
Contact information
Practice address
118 COLLEGE DR, HATTIESBURG, MS 39406-0001
(601) 266-1000
Mailing address
322 JANET LN, HATTIESBURG, MS 39402-7418
(769) 234-4319
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT-1027
MS
2255A2300X
Athletic Trainer
AT003649
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
802354215
BLUE CROSS BLUE SHIELD
MS
Enumeration date
07/23/2019
Last updated
07/18/2022
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