Provider Demographics
NPI:1588426928
Name:MAUZER, RILEY
Entity type:Individual
Prefix:
First Name:RILEY
Middle Name:
Last Name:MAUZER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 515
Mailing Address - Street 2:
Mailing Address - City:BOULDER JUNCTION
Mailing Address - State:WI
Mailing Address - Zip Code:54512-0515
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6676 CAROLA DR
Practice Address - Street 2:
Practice Address - City:PRESQUE ISLE
Practice Address - State:WI
Practice Address - Zip Code:54557-3200
Practice Address - Country:US
Practice Address - Phone:715-892-8713
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-30
Last Update Date:2024-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer