Individual
JAMES BRENDAN RIVES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1001 E PRIMROSE ST, SPRINGFIELD, MO 65807-5155
(417) 875-3742
Mailing address
PO BOX 802843, KANSAS CITY, MO 64180-2843
(417) 875-3000
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2022005480
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
220106591
—
MO
Enumeration date
02/16/2022
Last updated
04/26/2022
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