Individual
DR. ALICE R. RIEDEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
520 E JACKSON ST, WILLARD, MO 65781-9200
(417) 742-2300
(417) 742-2335
Mailing address
PO BOX 2580, SPRINGFIELD, MO 65801-2580
(417) 829-4620
(417) 829-4316
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2004025508
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
208373506
—
MO
Enumeration date
02/01/2007
Last updated
01/22/2014
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