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General NPI Number Information
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NPI Number | 1588799225
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Entity Type | Organization
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Legal Business Name | CORBETT R. RILEY, DC, A CHIROPRACTIC CORPORATION
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Dates
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Enumeration Date | 02/22/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 104 CATHERINE LN
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City | GRASS VALLEY
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State | CA
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Zip | 95945-5701
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Country | US
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Telephone | 530-477-8081
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Fax | 530-477-8081
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Provider Business Mailing Address
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Address Line | 104 CATHERINE LN
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City | GRASS VALLEY
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State | CA
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Zip | 95945-5701
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Country | US
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Telephone | 530-477-8081
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Fax | 530-477-8081
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Authorized Official
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Title or Position | CHIROPRACTOR BUSINESS OWNER
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Name | DR. CORBETT R RILEY
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Credential | DC
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Telephone | 530-477-8081
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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 | 19960
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License Number State | CA
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