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General NPI Number Information
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NPI Number | 1255870119
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Entity Type | Individual
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Provider Name | DANIEL RIASE DC
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Gender | Male
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Dates
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Enumeration Date | 02/13/2017
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Last Update Date | 12/24/2021
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Provider Practice Location Address
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Address Line | 3915 CASCADE RD SW STE T-155
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City | ATLANTA
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State | GA
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Zip | 30331-8512
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Country | US
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Telephone | 678-649-2131
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Fax | 678-649-2132
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Provider Business Mailing Address
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Address Line | 3000 WINDY HILL RD SE UNIT 674591
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City | MARIETTA
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State | GA
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Zip | 30006-0201
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Country | US
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Telephone | 678-649-2131
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Fax | 678-649-2132
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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 | 2553-I
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License Number State | AL
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | CHIR009897
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License Number State | GA
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