Organization
E C RIDER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MITCHELL PAUL RIDER DPM (PODIATRIST)
(979) 922-9800
Entity
Organization
Contact information
Practice address
2815 STEVEN DR, JOHNSON CITY, TN 37604-1936
(979) 922-9800
Mailing address
2815 STEVEN DR, JOHNSON CITY, TN 37604-1936
(979) 922-9800
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
—
—
313M00000X
Nursing Facility/Intermediate Care Facility
Primary
—
—
Other
Enumeration date
05/16/2023
Last updated
05/16/2023
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