Provider Demographics
NPI:1992394878
Name:DOWNING, RILEY
Entity Type:Individual
Prefix:
First Name:RILEY
Middle Name:
Last Name:DOWNING
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 1:310 CHINDIT BLVD S
Mailing Address - Street 2:
Mailing Address - City:CLOVIS
Mailing Address - State:NM
Mailing Address - Zip Code:88103-5311
Mailing Address - Country:US
Mailing Address - Phone:575-904-3936
Mailing Address - Fax:
Practice Address - Street 1:310 CHINDIT BLVD S
Practice Address - Street 2:
Practice Address - City:CLOVIS
Practice Address - State:NM
Practice Address - Zip Code:88103-5311
Practice Address - Country:US
Practice Address - Phone:575-904-3936
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-14
Last Update Date:2021-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMAT7762255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer