Individual
VICROR RIVERA JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2530 S TELSHOR BLVD, SUITE 107, LAS CRUCES, NM 88011-4907
(575) 571-3595
Mailing address
2521 N MAIN UNIT 1 - 173, LAS CRUCES, NM 88001-1154
(575) 571-3595
Taxonomy
Speciality
Code
Description
License number
State
222Z00000X
Orthotist
Primary
—
—
Other
Enumeration date
04/30/2009
Last updated
04/30/2009
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