Individual
RILEY BRYDAN LIDDELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3508 12TH AVE NE, OLYMPIA, WA 98506-5218
(360) 459-1099
Mailing address
3508 12TH AVE NE, OLYMPIA, WA 98506-5218
Taxonomy
Speciality
Code
Description
License number
State
222Z00000X
Orthotist
Primary
—
—
Other
Enumeration date
08/09/2017
Last updated
08/09/2017
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