Individual
CHARLES RIVA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4461 N. PROGRESS BLVD., PERU, IL 61354
(815) 223-9678
(815) 223-9683
Mailing address
826 CLARK ST, OGLESBY, IL 61348-1176
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Enumeration date
01/28/2011
Last updated
01/28/2011
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