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1225007834
RICHARD LESLIE RILES
FORT WAYNE, IN
NPI
1225007834
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
2255A2300X Specialist/Technologist Athletic Trainer
(Licence: IN 36000586A)
Enumeration Date
2006-03-16
Last Update Date
2016-03-02
Business Address
MR. RICHARD LESLIE RILES ATC
11130 PARKVIEW CIRCLE DR
FORT WAYNE, IN 46845-1735
Phone number: 260-417-1072
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Mailing Address
MR. RICHARD LESLIE RILES ATC
20427 PASADA DR
MONROEVILLE, IN 46773-9203
Phone number: 260-623-6068
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