Individual
KEVIN RICHARD WAYNE RIEGLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
18424 N 51ST AVE, GLENDALE, AZ 85308-1443
(602) 618-5443
Mailing address
7397 W TOPEKA DR, GLENDALE, AZ 85308-5608
(602) 618-5443
Taxonomy
Speciality
Code
Description
License number
State
246Z00000X
Other Specialist/Technologist
Primary
0517
AZ
Other
Enumeration date
03/15/2016
Last updated
03/15/2016
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