Provider Demographics
NPI:1679809479
Name:RIOS, RICARDO JR
Entity Type:Individual
Prefix:DR
First Name:RICARDO
Middle Name:
Last Name:RIOS
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:530 DEMOSS STREET
Mailing Address - Street 2:
Mailing Address - City:LORDSBURG
Mailing Address - State:NM
Mailing Address - Zip Code:88045-2618
Mailing Address - Country:US
Mailing Address - Phone:575-542-8384
Mailing Address - Fax:575-542-8367
Practice Address - Street 1:530 DEMOSS STREET
Practice Address - Street 2:
Practice Address - City:LORDSBURG
Practice Address - State:NM
Practice Address - Zip Code:88045-2618
Practice Address - Country:US
Practice Address - Phone:575-542-8384
Practice Address - Fax:575-542-8367
Is Sole Proprietor?:No
Enumeration Date:2009-10-29
Last Update Date:2012-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM1993111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor