Provider Demographics
NPI:1356469027
Name:RIOS & POWELL, A MEDICAL CORPORATION
Entity Type:Organization
Organization Name:RIOS & POWELL, A MEDICAL CORPORATION
Other - Org Name:VISALIA INDUSTRIAL MEDICINE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:LONNIE
Authorized Official - Middle Name:R
Authorized Official - Last Name:POWELL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:559-732-7680
Mailing Address - Street 1:220 S MOONEY BLVD
Mailing Address - Street 2:STE D
Mailing Address - City:VISALIA
Mailing Address - State:CA
Mailing Address - Zip Code:93291-4550
Mailing Address - Country:US
Mailing Address - Phone:559-732-7680
Mailing Address - Fax:559-732-8510
Practice Address - Street 1:220 S MOONEY BLVD
Practice Address - Street 2:STE D
Practice Address - City:VISALIA
Practice Address - State:CA
Practice Address - Zip Code:93291-4550
Practice Address - Country:US
Practice Address - Phone:559-732-7680
Practice Address - Fax:559-732-8510
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-27
Last Update Date:2010-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC12021111NX0100X
CAG68067208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NX0100XChiropractic ProvidersChiropractorOccupational HealthGroup - Single Specialty
No208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DL007AMedicare PIN