Individual
RICHARD ONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC, LAT
Contact information
Practice address
269 SOUTHVIEW AVE APT 2, MOSCOW, ID 83843-5072
(909) 489-1731
Mailing address
269 SOUTHVIEW AVE APT 2, MOSCOW, ID 83843-5072
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
10/22/2021
Last updated
10/22/2021
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