Individual
MR. RICHARD LESLIE RILES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
11130 PARKVIEW CIRCLE DR, FORT WAYNE, IN 46845-1735
(260) 417-1072
Mailing address
20427 PASADA DR, MONROEVILLE, IN 46773-9203
(260) 623-6068
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
36000586A
IN
Other
Enumeration date
03/16/2006
Last updated
03/02/2016
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