Provider Demographics
NPI:1285189167
Name:RILEY, MELISSA WOODS (DVM)
Entity Type:Individual
Prefix:DR
First Name:MELISSA
Middle Name:WOODS
Last Name:RILEY
Suffix:
Gender:F
Credentials:DVM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:389 W 1830 S
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84115-5890
Mailing Address - Country:US
Mailing Address - Phone:801-463-6488
Mailing Address - Fax:801-463-6610
Practice Address - Street 1:389 W 1830 S
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84115-5890
Practice Address - Country:US
Practice Address - Phone:801-463-6488
Practice Address - Fax:801-463-6610
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-19
Last Update Date:2016-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT9539526-2801247200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other