Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NX0800X | Chiropractor Orthopedic Specialist | 038-010588 | IL |
NPI | 1427068998 |
---|---|
Provider Name | Dr. Brittani Leah Riggio |
First Address | Louisville, IL 62858 |
Second Address | Louisville, IL 62858 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/08/2006 |
Last Update Date | 26/10/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
20-4649831 | FEIN # (01) | IL |