Provider Demographics
NPI:1972872232
Name:FRIGAARD RIES CHIROPRACTIC
Entity Type:Organization
Organization Name:FRIGAARD RIES CHIROPRACTIC
Other - Org Name:WHOLE BODY WELLNESS
Other - Org Type:Other Name
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MICAH
Authorized Official - Middle Name:
Authorized Official - Last Name:RIES
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:951-683-9807
Mailing Address - Street 1:6391 MAGNOLIA AVE
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92506-2424
Mailing Address - Country:US
Mailing Address - Phone:951-683-9807
Mailing Address - Fax:951-824-7555
Practice Address - Street 1:6391 MAGNOLIA AVE
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92506-2424
Practice Address - Country:US
Practice Address - Phone:951-683-9807
Practice Address - Fax:951-824-7555
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-15
Last Update Date:2011-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC 29448111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty