Individual
KEVIN RIDDLE
Active
Individual
KEVIN RIDDLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CMT, LMT, LMTI
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
5170
NM
225700000X
Massage Therapist
Primary
8934
CO
Other
Enumeration date
01/05/2010
Last updated
05/12/2011
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