Provider Demographics
NPI:1023358975
Name:RILEY, ANN MARGARET (MS)
Entity Type:Individual
Prefix:
First Name:ANN
Middle Name:MARGARET
Last Name:RILEY
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1323 NW CHERRY AVE
Mailing Address - Street 2:
Mailing Address - City:LAWTON
Mailing Address - State:OK
Mailing Address - Zip Code:73507-5210
Mailing Address - Country:US
Mailing Address - Phone:580-512-1676
Mailing Address - Fax:
Practice Address - Street 1:1323 NW CHERRY AVE
Practice Address - Street 2:
Practice Address - City:LAWTON
Practice Address - State:OK
Practice Address - Zip Code:73507-5210
Practice Address - Country:US
Practice Address - Phone:580-512-1676
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-28
Last Update Date:2013-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor