| Doctor Name: | JOEY RIVERA |
| NPI Number: | 1194151233 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | NREMT-B |
| License Number: | E1863404 |
| Business Practice Address: | Lyster Army Health Clinic Building 301 Andrews Avenue Fort Rucker, GA - 363625333 |
| Business Phone Number: | 3342557636 |
| Business Fax Number: | 3342557368 |
| Mailing Address: | Lyster Army Health Clinic, Building 301 Andrews Avenue FORT RUCKER |
| State: | GA |
| Postal Code: | 363625333 |
| Phone Number: | 3342557636 |
| Fax Number: | 3342557368 |
| NPI Enumeration Date: | 09/20/2013 |
| NPI Last Update Date: | 09/20/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 146N00000X |
| License Number: | E1863404 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TX |
| Taxonomy Type: | Emergency Medical Service Providers |
| Taxonomy Classification: | Emergency Medical Technician, Basic |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A Basic EMT is an individual trained and certified to perform basic life support treatment in medical emergencies based on individual state boards. |