Healthcare Provider Details

I. General information

NPI: 1497305346
Provider Name (Legal Business Name): RILEY K TUININGA D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/12/2019
Last Update Date: 10/18/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 BIDDLE AVENUE SUITE 204
NEWARK DE
19702-3966
US

IV. Provider business mailing address

200 BIDDLE AVENUE SUITE 204
NEWARK DE
19702-3966
US

V. Phone/Fax

Practice location:
  • Phone: 302-832-3369
  • Fax: 302-832-5854
Mailing address:
  • Phone: 302-832-3369
  • Fax: 302-832-5854

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberF1-0000997
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: