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NPI Code Detail

MEDICARE: KEVIN T RIEHL

MEDICARE: KEVIN T RIEHL
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YA0400XAddiction (Substance Use Disorder) Counselor

General Provider Information

NPI Number : 1316269665
Entity Type Code : Individual
Provider Name (Legal Business Name) : KEVIN T RIEHL
Provider Business Mailing Address
First Line : 3600 SAN JERONIMO DR STE 210
Second Line :
City : ANCHORAGE
State : AK
Zip : 99508-2870
Country : US
Telephone Number : 907-793-3200
Fax Number : 907-793-3250
Provider Business Practice Location Address
First Line : 3600 SAN JERONIMO DR STE 210
Second Line :
City : ANCHORAGE
State : AK
Zip : 99508-2870
Country : US
Telephone Number : 907-793-3200
Fax Number : 907-793-3250
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/26/2010
Last Update Date : 05/07/2019

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