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Organization

RIVERSIDE PHYSICIAN SERVICES INC

Active
Parent organization
RIVERSIDE HEALTHCARE ASSOC
Other names
Riverside Primary Care Kiln Creek, Riverside Primary Care KLN Creek
Organization subpart
Yes

Provider details

NPI number
Legal business name
RIVERSIDE HEALTHCARE ASSOC
Authorized official
BRADEN MILLER (CFO)
(757) 316-5900
Entity
Organization

Contact information

Practice address
209 VILLAGE AVE STE P, YORKTOWN, VA 23693-5639
(757) 316-5050
Mailing address
856 J CLYDE MORRIS BLVD STE A, NEWPORT NEWS, VA 23601-1318
(757) 316-5900
(757) 534-5190

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary

Other

Enumeration date
10/03/2017
Last updated
10/03/2017
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