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General NPI Number Information
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NPI Number | 1134526502
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Entity Type | Individual
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Provider Name | RILEY SOWLE D.C.
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Gender | Male
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Dates
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Enumeration Date | 12/01/2014
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Last Update Date | 04/16/2015
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Provider Practice Location Address
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Address Line | 1835 GATEWAY DR. SUITE 104
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City | COON RAPIDS
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State | MN
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Zip | 55448-1469
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Country | US
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Telephone | 763-710-8888
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Fax |
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Provider Business Mailing Address
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Address Line | 1480 126TH LN NW
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City | COON RAPIDS
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State | MN
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Zip | 55448-1469
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Country | US
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Telephone | 763-742-6659
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 5993
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License Number State | MN
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