Provider Demographics
NPI:1316182587
Name:RIORDAN, COLIN T (HCP, MBA)
Entity Type:Individual
Prefix:MR
First Name:COLIN
Middle Name:T
Last Name:RIORDAN
Suffix:
Gender:M
Credentials:HCP, MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:942 WOODY HILL CIR
Mailing Address - Street 2:
Mailing Address - City:EVANS
Mailing Address - State:GA
Mailing Address - Zip Code:30809-6714
Mailing Address - Country:US
Mailing Address - Phone:706-840-1619
Mailing Address - Fax:706-364-3187
Practice Address - Street 1:4210 COLUMBIA RD
Practice Address - Street 2:SUITE 5B
Practice Address - City:MARTINEZ
Practice Address - State:GA
Practice Address - Zip Code:30907-0401
Practice Address - Country:US
Practice Address - Phone:706-364-3184
Practice Address - Fax:706-364-3187
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-02
Last Update Date:2023-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAHADS000775237700000X
SCHAS0475237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist