MEDICARE: RIES CHIROPRACTIC ASSOCIATES APC

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
1	111N00000X	Chiropractor	DC29448	CA

General Provider Information

NPI Number	:	1922497023
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RIES CHIROPRACTIC ASSOCIATES APC

Provider Business Mailing Address
First Line	:	15550 ROCKFIELD BLVD STE B220
Second Line	:
City	:	IRVINE
State	:	CA
Zip	:	92618-6703
Country	:	US
Telephone Number	:	949-598-9999
Fax Number	:	949-598-9990

Provider Business Practice Location Address
First Line	:	205 E PINE ST
Second Line	:
City	:	FORT BRAGG
State	:	CA
Zip	:	95437-3306
Country	:	US
Telephone Number	:	707-962-3067
Fax Number	:

Authorized Official
Title or Position	:	OWNER/PROVIDER
Name	:	DR. MICAH RIES
Credential	:	DC
Telephone Number	:	951-359-1229

Provider Enumeration Date	:	01/13/2015
Last Update Date	:	03/02/2023

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