Individual
ELLIOTT RIDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
52 JAY ST, FEASTERVILLE TREVOSE, PA 19053-4318
(215) 880-6843
Mailing address
52 JAY ST, FEASTERVILLE TREVOSE, PA 19053-4318
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
12/01/2016
Last updated
12/01/2016
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