Provider Demographics
NPI:1881820975
Name:RIOUX, JEFFREY A (LMT)
Entity Type:Individual
Prefix:MR
First Name:JEFFREY
Middle Name:A
Last Name:RIOUX
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1021 FALCON DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MO
Mailing Address - Zip Code:65201-6235
Mailing Address - Country:US
Mailing Address - Phone:573-881-4466
Mailing Address - Fax:
Practice Address - Street 1:5 S 9TH ST STE 203
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65201-7710
Practice Address - Country:US
Practice Address - Phone:573-881-4466
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-03
Last Update Date:2009-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2001018991172M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172M00000XOther Service ProvidersMechanotherapist