Individual
NATHAN DAVID RIEDER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MOT OTR/L
Contact information
Practice address
500 W COURT ST, KANKAKEE, IL 60901-3661
(815) 937-8220
Mailing address
PO BOX 55, ASHKUM, IL 60911-0055
(815) 698-5025
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
056.006688
IL
Other
Enumeration date
07/11/2012
Last updated
07/11/2012
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