Provider Demographics
NPI:1225389943
Name:PEDDY, RION LEIGH (DC)
Entity Type:Individual
Prefix:DR
First Name:RION
Middle Name:LEIGH
Last Name:PEDDY
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:7001 ORCHARD LAKE RD STE 332
Mailing Address - Street 2:
Mailing Address - City:WEST BLOOMFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48322-3661
Mailing Address - Country:US
Mailing Address - Phone:482-862-5355
Mailing Address - Fax:482-234-6335
Practice Address - Street 1:7001 ORCHARD LAKE RD STE 332
Practice Address - Street 2:
Practice Address - City:WEST BLOOMFIELD
Practice Address - State:MI
Practice Address - Zip Code:48322-3661
Practice Address - Country:US
Practice Address - Phone:482-862-5355
Practice Address - Fax:482-234-6335
Is Sole Proprietor?:No
Enumeration Date:2012-09-20
Last Update Date:2018-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301010016111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor