Provider Demographics
NPI:1154828572
Name:RIOS AND MILES CHIROPRACTIC INCORPORATED
Entity type:Organization
Organization Name:RIOS AND MILES CHIROPRACTIC INCORPORATED
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RAFAEL
Authorized Official - Middle Name:AUGUSTO
Authorized Official - Last Name:RIOS
Authorized Official - Suffix:II
Authorized Official - Credentials:DC
Authorized Official - Phone:909-561-8611
Mailing Address - Street 1:1232 N PARK AVE
Mailing Address - Street 2:
Mailing Address - City:POMONA
Mailing Address - State:CA
Mailing Address - Zip Code:91768-3029
Mailing Address - Country:US
Mailing Address - Phone:909-623-9621
Mailing Address - Fax:909-623-0064
Practice Address - Street 1:9135 ARCHIBALD AVE STE C
Practice Address - Street 2:
Practice Address - City:RANCHO CUCAMONGA
Practice Address - State:CA
Practice Address - Zip Code:91730-5227
Practice Address - Country:US
Practice Address - Phone:909-561-8611
Practice Address - Fax:909-623-0064
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-11
Last Update Date:2018-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC26480111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitationGroup - Single Specialty