Individual
RILEY HAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
109 MEDICAL PARK DR STE C, ANDALUSIA, AL 36420-5364
(334) 222-1818
(334) 222-1919
Mailing address
109 MEDICAL PARK DR STE C, ANDALUSIA, AL 36420-5364
(334) 222-1818
(334) 222-1919
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
C3682A
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C3682A
APC
AL
Enumeration date
06/02/2021
Last updated
06/02/2021
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