Provider Demographics
NPI:1679213201
Name:STORIE, RICHARD MALCOLM II (EDD, ACSM-EP)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:MALCOLM
Last Name:STORIE
Suffix:II
Gender:M
Credentials:EDD, ACSM-EP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9570 MOUNT AYRE WAY
Mailing Address - Street 2:
Mailing Address - City:MURFREESBORO
Mailing Address - State:TN
Mailing Address - Zip Code:37129-7808
Mailing Address - Country:US
Mailing Address - Phone:615-478-1102
Mailing Address - Fax:
Practice Address - Street 1:9570 MOUNT AYRE WAY
Practice Address - Street 2:
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37129-7808
Practice Address - Country:US
Practice Address - Phone:615-478-1102
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-31
Last Update Date:2022-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Y00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersClinical Exercise Physiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1043080OtherACSM