Provider Demographics
NPI:1962495366
Name:RILEY, CINDY L (MS,, ATC)
Entity Type:Individual
Prefix:MS
First Name:CINDY
Middle Name:L
Last Name:RILEY
Suffix:
Gender:F
Credentials:MS,, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1421 BECKFORD CT
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:MD
Mailing Address - Zip Code:21804-2061
Mailing Address - Country:US
Mailing Address - Phone:443-944-0886
Mailing Address - Fax:
Practice Address - Street 1:1015 BEAGLIN PARK DR
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:MD
Practice Address - Zip Code:21804-9311
Practice Address - Country:US
Practice Address - Phone:410-677-5143
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-08-31
Last Update Date:2011-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD2255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer