Individual
MR. KEVIN PAUL RILEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT, NCTMB
Contact information
Practice address
147 PALM ST, BANGOR, ME 04401-4021
(207) 356-2895
Mailing address
360 CHURCH RD, BANGOR, ME 04401-2138
(207) 356-2895
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT3184
ME
Other
Enumeration date
03/20/2007
Last updated
07/08/2007
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