Healthcare Provider Details

I. General information

NPI: 1356469027
Provider Name (Legal Business Name): RIOS & POWELL, A MEDICAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/27/2007
Last Update Date: 09/10/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

220 S MOONEY BLVD STE D
VISALIA CA
93291-4550
US

IV. Provider business mailing address

220 S MOONEY BLVD STE D
VISALIA CA
93291-4550
US

V. Phone/Fax

Practice location:
  • Phone: 559-732-7680
  • Fax: 559-732-8510
Mailing address:
  • Phone: 559-732-7680
  • Fax: 559-732-8510

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberG68067
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code111NX0100X
TaxonomyOccupational Health Chiropractor
License NumberDC12021
License Number StateCA

VIII. Authorized Official

Name: DR. LONNIE R. POWELL
Title or Position: CEO
Credential: DC
Phone: 559-732-7680