Healthcare Provider Details
I. General information
NPI: 1003826850
Provider Name (Legal Business Name): RICHARD RILEY D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 08/08/2006
Last Update Date: 12/23/2013
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1100 W 3RD ST
LITTLE ROCK AR
72201-2008
US
IV. Provider business mailing address
1100 W 3RD ST
LITTLE ROCK AR
72201-2008
US
V. Phone/Fax
- Phone: 501-371-0022
- Fax: 501-371-0810
- Phone: 501-371-0022
- Fax: 501-371-0810
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 111NX0800X |
| Taxonomy | Orthopedic Chiropractor |
| License Number | 887 |
| License Number State | AR |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: