Organization
KATY RIEVES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CLARK RIEVES (VICE PRESIDENT)
(970) 256-1664
Entity
Organization
Contact information
Practice address
2139 N 12TH ST, SUITE 2, GRAND JUNCTION, CO 81501-2901
(970) 256-1664
Mailing address
2139 N 12TH ST, SUITE 2, GRAND JUNCTION, CO 81501-2901
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
37919
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
462278
MEDICARE GROUP NUMBER
CO
Enumeration date
12/05/2007
Last updated
12/05/2007
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