Provider Demographics
NPI:1073515896
Name:RIEGER, CHRIS LOUIS (CO LO ORTHOTIST)
Entity type:Individual
Prefix:MR
First Name:CHRIS
Middle Name:LOUIS
Last Name:RIEGER
Suffix:
Gender:M
Credentials:CO LO ORTHOTIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24643 RED ROBIN DR
Mailing Address - Street 2:
Mailing Address - City:BONITA SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:34135-7085
Mailing Address - Country:US
Mailing Address - Phone:239-947-7906
Mailing Address - Fax:239-947-7906
Practice Address - Street 1:24643 RED ROBIN DR
Practice Address - Street 2:
Practice Address - City:BONITA SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:34135-7085
Practice Address - Country:US
Practice Address - Phone:239-947-7906
Practice Address - Fax:239-947-7906
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-11
Last Update Date:2008-02-05
Deactivation Date:2006-03-22
Deactivation Code:
Reactivation Date:2006-03-27
Provider Licenses
StateLicense IDTaxonomies
FL641744P3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1744P3200XOther Service ProvidersSpecialistProsthetics Case Management