Individual
MR. RILEY MICHAEL WILLIAMS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
507 GORDON ST., WILEY, CO 81092-0263
(719) 252-1640
Mailing address
PO BOX 263, 507 GORDON ST., WILEY, CO 81092-0263
(719) 252-1640
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT.0001554
CO
Other
Enumeration date
12/13/2016
Last updated
12/13/2016
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