Individual
PROF. JOSE E RIVERA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC.
Contact information
Practice address
425 ALPINE VILLAGE DR, MONROEVILLE, PA 15146-3752
(724) 931-0628
Mailing address
425 ALPINE VILLAGE DR, MONROEVILLE, PA 15146-3752
(724) 931-0628
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
RT001163A
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RT001163A
STATE LICENSE
PA
Enumeration date
02/09/2017
Last updated
02/09/2017
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