Individual
GARY FONTA RILEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2660 OLD BAINBRIDGE RD APT 1407, TALLAHASSEE, FL 32303-3573
(850) 405-5646
Mailing address
2660 OLD BAINBRIDGE RD APT 1407, TALLAHASSEE, FL 32303-3573
(850) 405-5646
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
03/12/2019
Last updated
03/12/2019
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