Provider Demographics
NPI:1992411425
Name:MINORIK, RILEY MITCHELL
Entity type:Individual
Prefix:DR
First Name:RILEY
Middle Name:MITCHELL
Last Name:MINORIK
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2620 W MARKET ST
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44313-4204
Mailing Address - Country:US
Mailing Address - Phone:330-869-6566
Mailing Address - Fax:
Practice Address - Street 1:2620 W MARKET ST
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44313-4204
Practice Address - Country:US
Practice Address - Phone:330-869-6566
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-27
Last Update Date:2023-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHDC-05219111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor