Organization
RICHARD L REILLY DPM
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RICHARD L REILLY DPM (OWNER)
(724) 459-3411
Entity
Organization
Contact information
Practice address
40 E MARKET ST, BLAIRSVILLE, PA 15717-1370
(724) 459-3411
(724) 459-3412
Mailing address
40 E MARKET ST, BLAIRSVILLE, PA 15717-1370
(724) 459-3411
(724) 459-3412
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
SC003861
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0015223780005
—
PA
01
—
761516
BCBS
PA
Enumeration date
05/14/2007
Last updated
08/22/2020
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