Individual
JOANNA LYNN RILEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LOT
Contact information
Practice address
1211 ROYALTY AVE, ODESSA, TX 79761-2952
(432) 638-4544
Mailing address
PO BOX 14774, ODESSA, TX 79768-4774
(432) 638-4544
Taxonomy
Speciality
Code
Description
License number
State
225XP0019X
Physical Rehabilitation Occupational Therapist
Primary
109122
TX
Other
Enumeration date
10/24/2011
Last updated
10/24/2011
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