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General NPI Number Information
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NPI Number | 1518193093
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Entity Type | Organization
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Legal Business Name | LORRI A. RILEY, DPM PC
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Dates
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Enumeration Date | 06/10/2009
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Last Update Date | 04/03/2014
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Provider Practice Location Address
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Address Line | 1410 NORTH AVE #1
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City | SPEARFISH
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State | SD
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Zip | 57783
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Country | US
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Telephone | 605-722-3668
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Fax | 480-393-5577
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Provider Business Mailing Address
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Address Line | 927 E COLORADO BLVD
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City | SPEARFISH
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State | SD
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Zip | 57783-2783
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Country | US
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Telephone | 605-722-3668
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Fax | 480-393-5577
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Authorized Official
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Title or Position | OWNER
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Name | LORRI RILEY
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Credential | DPM
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Telephone | 605-722-3668
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | 130
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License Number State | SD
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