Healthcare Provider Details

I. General information

NPI: 1295643401
Provider Name (Legal Business Name): RILEY KLIETHERMES DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/29/2026
Last Update Date: 08/29/2026
Certification Date: 08/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21 CONLEY RD STE L2
COLUMBIA MO
65201-6484
US

IV. Provider business mailing address

2906 FLORA DR
COLUMBIA MO
65202-2237
US

V. Phone/Fax

Practice location:
  • Phone: 573-607-1888
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number2025002290
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: