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Individual

DR. CHRISTIAN GABRIEL RIVERA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.C.

Contact information

Practice address
1821 S RIDGEWOOD AVE, SOUTH DAYTONA, FL 32119-2258
(314) 609-2006
Mailing address
PO BOX 291794, PORT ORANGE, FL 32129-1794
(314) 609-2006

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
2006033754
MO
111N00000X
Chiropractor
Primary
428
PR
111N00000X
Chiropractor
IL

Other

Enumeration date
08/16/2007
Last updated
08/16/2007
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