Individual
MARK ANTHONY RIVERS JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
6300 SOUTH AVE APT 301, BOARDMAN, OH 44512-3658
(206) 538-9984
Mailing address
6300 SOUTH AVE APT 301, BOARDMAN, OH 44512-3658
(206) 538-9984
Taxonomy
Speciality
Code
Description
License number
State
174200000X
Meals Provider
—
—
347C00000X
Private Vehicle
—
—
376J00000X
Homemaker
Primary
—
—
Other
Enumeration date
03/26/2025
Last updated
03/26/2025
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