Individual
MS. ETTA MARIE RILEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CEO/OWNER
Contact information
Practice address
3622 PENN AVE N, MINNEAPOLIS, MN 55412-1934
(612) 522-3370
Mailing address
3622 PENN AVE N, MINNEAPOLIS, MN 55412-1934
(612) 522-3370
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
M933160273015
MN
Other
Enumeration date
12/23/2019
Last updated
12/23/2019
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