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General NPI Number Information
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NPI Number | 1871549659
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Entity Type | Individual
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Provider Name | WILLIAM B RISLEY JR. D.C.
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Gender | Male
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Dates
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Enumeration Date | 05/25/2006
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Last Update Date | 08/22/2017
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Provider Practice Location Address
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Address Line | 16620 N 40TH ST BUILDING I, SUITE 2
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City | PHOENIX
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State | AZ
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Zip | 85032-4798
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Country | US
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Telephone | 602-493-0004
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Fax | 602-493-0761
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Provider Business Mailing Address
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Address Line | 15207 N 54TH PL
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City | SCOTTSDALE
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State | AZ
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Zip | 85254-2395
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Country | US
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Telephone | 602-818-2257
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Fax | 602-493-0761
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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 | 5688
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License Number State | AZ
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