Individual
KIMBERLY RILEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3030 RANDOLPH RD, SUITE 102, CHARLOTTE, NC 28211-1368
(704) 512-4475
Mailing address
3030 RANDOLPH RD, CHARLOTTE, NC 28211-1368
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
9501563
NC
Other
Enumeration date
07/26/2006
Last updated
12/14/2018
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