Provider Demographics
NPI:1902298763
Name:BARRETT, RILEY JAMES (DC)
Entity type:Individual
Prefix:DR
First Name:RILEY
Middle Name:JAMES
Last Name:BARRETT
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 1:1425 LIGHT ST
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21230-4514
Mailing Address - Country:US
Mailing Address - Phone:410-752-2330
Mailing Address - Fax:410-837-1595
Practice Address - Street 1:1425 LIGHT ST
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21230-4514
Practice Address - Country:US
Practice Address - Phone:410-752-2330
Practice Address - Fax:410-837-1595
Is Sole Proprietor?:No
Enumeration Date:2015-03-03
Last Update Date:2015-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDS03832111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor