Provider Demographics
NPI:1528334430
Name:RIEGEL, NOAH MICHAEL (DC)
Entity type:Individual
Prefix:DR
First Name:NOAH
Middle Name:MICHAEL
Last Name:RIEGEL
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 1:10745 SLEEPY BROOK WAY
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33428-5741
Mailing Address - Country:US
Mailing Address - Phone:561-251-4565
Mailing Address - Fax:
Practice Address - Street 1:9250 GLADES RD
Practice Address - Street 2:SUITE 111
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33434-3958
Practice Address - Country:US
Practice Address - Phone:561-479-2880
Practice Address - Fax:561-479-0843
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-25
Last Update Date:2014-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH10569111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor