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Organization

RICHARD RIVERA MDPC

Active
Parent organization
RICHARD RIVERA MDPC
Other names
Health Trac LLC
Organization subpart
Yes

Provider details

NPI number
Legal business name
RICHARD RIVERA MDPC
Authorized official
JANET R ORTIZ (MANAGER)
(719) 564-9400
Entity
Organization

Contact information

Practice address
127 JUSTICE CENTER RD STE J, CANON CITY, CO 81212-9378
(719) 269-1136
(719) 269-1186
Mailing address
127 JUSTICE CENTER RD STE J, CANON CITY, CO 81212-9378
(719) 269-1136
(719) 269-1186

Taxonomy

Speciality
Code
Description
License number
State
261QU0200X
Urgent Care Clinic/Center
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
61024821
CO
Enumeration date
04/14/2021
Last updated
04/14/2021
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