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General NPI Number Information
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NPI Number | 1740814292
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Entity Type | Individual
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Provider Name | ERIC YANIEL RIVERA-CRUZ DC
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Gender | Male
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Dates
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Enumeration Date | 02/24/2020
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Last Update Date | 02/24/2020
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Provider Practice Location Address
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Address Line | 715 S THORNTON AVE
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City | DALTON
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State | GA
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Zip | 30720-8213
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Country | US
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Telephone | 706-609-0023
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Fax |
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Provider Business Mailing Address
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Address Line | 5721 BATTLEFIELD PKWY
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City | RINGGOLD
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State | GA
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Zip | 30736-5154
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Country | US
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Telephone | 706-935-7729
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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 | 3273
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License Number State | TN
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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 | CHIR010336
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License Number State | GA
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