Provider Demographics
NPI:1568468536
Name:RILEY, CYNTHIA LEE (DC,CCSP)
Entity Type:Individual
Prefix:DR
First Name:CYNTHIA
Middle Name:LEE
Last Name:RILEY
Suffix:
Gender:F
Credentials:DC,CCSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2871 TRENT RD
Mailing Address - Street 2:
Mailing Address - City:NEW BERN
Mailing Address - State:NC
Mailing Address - Zip Code:28562-2029
Mailing Address - Country:US
Mailing Address - Phone:252-514-2273
Mailing Address - Fax:252-514-2276
Practice Address - Street 1:2871 TRENT RD
Practice Address - Street 2:
Practice Address - City:NEW BERN
Practice Address - State:NC
Practice Address - Zip Code:28562-2029
Practice Address - Country:US
Practice Address - Phone:252-514-2273
Practice Address - Fax:252-514-2276
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-24
Last Update Date:2010-07-01
Deactivation Date:2006-03-16
Deactivation Code:
Reactivation Date:2006-03-20
Provider Licenses
StateLicense IDTaxonomies
NC1850111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCU40903Medicare UPIN
NC2447867Medicare ID - Type Unspecified