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Individual
DR. JESSE ELLSWORTH RILEY
Active
Individual
DR. JESSE ELLSWORTH RILEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.P.M.
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
90377690501
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
90377690501
LICENSE
UT
Enumeration date
02/07/2012
Last updated
03/07/2023
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