# RIVERSIDE OSTEOPATHY LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1780030502
- **Authorized official:** GARRETT B EDWARDS DO (OWNER)
- **Authorized official phone:** (207) 899-8130

## Contact information

- **Practice address:** 40 MAIN ST, SUITE 131, BIDDEFORD, ME 04005-5173
- **Practice address phone:** (207) 899-8130
- **Practice address fax:** (207) 558-8258
- **Mailing address:** PO BOX 292, SACO, ME 04072-0292
- **Mailing address phone:** (207) 899-8130
- **Mailing address fax:** (207) 558-8258

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 204D00000X | Neuromusculoskeletal Medicine & OMM Physician | — | NULL | Yes |
| 204D00000X | Neuromusculoskeletal Medicine & OMM Physician | — | — | Yes |

## Other

- **Enumeration date:** 05/11/2016
- **Last updated:** 05/11/2016