Provider Demographics
NPI:1871249227
Name:O'CONNOR, RILEY SHEA
Entity Type:Individual
Prefix:
First Name:RILEY
Middle Name:SHEA
Last Name:O'CONNOR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:87 SPRUCE HILL AVE
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:MA
Mailing Address - Zip Code:01062-3414
Mailing Address - Country:US
Mailing Address - Phone:413-588-2022
Mailing Address - Fax:
Practice Address - Street 1:87 SPRUCE HILL AVE
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:MA
Practice Address - Zip Code:01062-3414
Practice Address - Country:US
Practice Address - Phone:413-588-2022
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-24
Last Update Date:2022-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer