Provider Demographics
NPI:1548644743
Name:RICHARDS, ZACHERY THOMAS (MS, SCAT, ATC)
Entity type:Individual
Prefix:MR
First Name:ZACHERY
Middle Name:THOMAS
Last Name:RICHARDS
Suffix:
Gender:M
Credentials:MS, SCAT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1051 SOUTHERN DR UNIT 3113
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29201-5631
Mailing Address - Country:US
Mailing Address - Phone:413-652-9746
Mailing Address - Fax:
Practice Address - Street 1:600 LYDIA DR
Practice Address - Street 2:
Practice Address - City:PELION
Practice Address - State:SC
Practice Address - Zip Code:29123-9812
Practice Address - Country:US
Practice Address - Phone:803-821-2258
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-17
Last Update Date:2021-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC2255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer