Individual
MR. GREGORY J RIVENBARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CAA
Taxonomy
Speciality
Code
Description
License number
State
367H00000X
Anesthesiologist Assistant
Primary
67000350
OH
Other
Enumeration date
05/23/2019
Last updated
04/08/2020
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