Healthcare Provider Details

I. General information

NPI: 1821080227
Provider Name (Legal Business Name): ROBERT ALAN RILEY D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/22/2005
Last Update Date: 07/08/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1225 SW SUMMIT HILL DR
LEES SUMMIT MO
64081-3270
US

IV. Provider business mailing address

1225 SW SUMMIT HILL DR
LEES SUMMIT MO
64081-3270
US

V. Phone/Fax

Practice location:
  • Phone: 816-516-2864
  • Fax:
Mailing address:
  • Phone: 816-516-2864
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number2001023492
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number2001023492
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: