Organization
BAYSIDE PODIATRY PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LORRI RILEY DPM (OWNER)
(605) 641-5794
Entity
Organization
Contact information
Practice address
927 E COLORADO BLVD, SPEARFISH, SD 57783-2783
(605) 641-5794
(480) 393-5577
Mailing address
PO BOX 422, SPEARFISH, SD 57783-0422
(605) 641-5794
(480) 393-5577
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
PO3166
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5320260001
DMERC
FL
01
—
65859Z
BLUE CROSS
FL
01
—
P00205681
MEDICARE RAILROAD
FL
Enumeration date
12/27/2006
Last updated
07/08/2009
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