Provider Demographics
NPI:1154557296
Name:RILEY, NICOLAS VAL (DC)
Entity type:Individual
Prefix:
First Name:NICOLAS
Middle Name:VAL
Last Name:RILEY
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5301 LONGLEY LN STE B43
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89511-1805
Mailing Address - Country:US
Mailing Address - Phone:775-829-8686
Mailing Address - Fax:775-829-1389
Practice Address - Street 1:5301 LONGLEY LN STE B43
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89511-1805
Practice Address - Country:US
Practice Address - Phone:775-829-8686
Practice Address - Fax:775-829-1389
Is Sole Proprietor?:No
Enumeration Date:2009-06-03
Last Update Date:2017-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVB01337111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor