Organization
RIDDLES BEAUTY SUPPLY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. BEVERLY ANN RIDDLE (OWNER)
(417) 781-8580
Entity
Organization
Contact information
Practice address
1917 E 20TH ST, JOPLIN, MO 64804-1017
(417) 781-8580
(417) 781-6656
Mailing address
PO BOX 4471, JOPLIN, MO 64803-4471
(417) 781-8580
(417) 781-6656
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
31433
BLUE CROSS BLUE SHIELD
MO
Enumeration date
09/02/2006
Last updated
04/20/2008
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