Individual
DR. SCOTT RIISE
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
101 BODIN CIR, 60TH MDOS/SGOL, TRAVIS AFB, CA 94535-1809
(707) 423-7372
Mailing address
3005 PUFFIN CIR, FAIRFIELD, CA 94533-8913
(850) 499-5305
Taxonomy
Speciality
Code
Description
License number
State
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
MD065261L
PA
Other
Enumeration date
10/04/2005
Last updated
07/08/2007
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