Individual
JOHNPAUL RIDDLES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
905 FAIRVIEW DR, GRIDLEY, CA 95948-2206
(805) 704-2176
Mailing address
905 FAIRVIEW DR, GRIDLEY, CA 95948-2206
(805) 704-2176
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
191432
CA
Other
Enumeration date
03/24/2017
Last updated
03/24/2017
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