Individual
NUTALIA RILEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3121 PHOENIX ST APT A, KENNER, LA 70065-5125
(504) 570-4110
Mailing address
3121 PHOENIX ST APT A, KENNER, LA 70065-5125
(504) 570-4110
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
007393835
LA
Other
Enumeration date
03/21/2020
Last updated
03/21/2020
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