Provider Demographics
NPI:1962615120
Name:RICHMOND, ERIN R (ATC, LAT)
Entity type:Individual
Prefix:MS
First Name:ERIN
Middle Name:R
Last Name:RICHMOND
Suffix:
Gender:F
Credentials:ATC, LAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10810 CENTER VILLAGE RD
Mailing Address - Street 2:
Mailing Address - City:GALENA
Mailing Address - State:OH
Mailing Address - Zip Code:43021-8606
Mailing Address - Country:US
Mailing Address - Phone:614-774-0861
Mailing Address - Fax:
Practice Address - Street 1:7333 SMITHS MILL RD
Practice Address - Street 2:
Practice Address - City:NEW ALBANY
Practice Address - State:OH
Practice Address - Zip Code:43054-9291
Practice Address - Country:US
Practice Address - Phone:614-775-6689
Practice Address - Fax:614-775-5068
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAT.0018432255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer