Doctor Name: | CAROL JONNETTE RILEY |
NPI Number: | 1205269156 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LMT |
License Number: | 009769 |
Business Practice Address: | 444 Columbus Rd Suite F Mount Vernon, OH - 430504461 |
Business Phone Number: | 7403970330 |
Business Fax Number: | 7403970060 |
Mailing Address: | 205 Wooster Rd, MOUNT VERNON |
State: | OH |
Postal Code: | 430501733 |
Phone Number: | 7403979040 |
Fax Number: | |
NPI Enumeration Date: | 08/14/2013 |
NPI Last Update Date: | 08/14/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | 009769 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OH |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |