Individual
MS. TIFFANY AMBER RILEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1005 GROVE RD FL 4, GREENVILLE, SC 29605-4630
(864) 455-6900
(864) 255-5619
Mailing address
300 E MCBEE AVE FL 4, GREENVILLE, SC 29601-2842
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
14722
MN
363A00000X
Physician Assistant
Primary
3215
SC
363A00000X
Physician Assistant
PA9108032
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
012656500
—
FL
Enumeration date
07/11/2014
Last updated
08/19/2024
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