Individual
BRUCE EDWARD RIECKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PSY.D.
Contact information
Practice address
5500 S SYCAMORE ST, LITTLETON, CO 80120-8201
(303) 723-5902
(303) 797-9354
Mailing address
17046 VINELAND DR, PARKER, CO 80134-7668
(303) 870-3136
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
3201
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CO303770
MEDICARE INDIVIDUAL PTAN
CO
Enumeration date
03/09/2007
Last updated
04/03/2009
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