Provider Demographics
NPI:1205981925
Name:RILEY, SHARON LAMBERT (DC)
Entity type:Individual
Prefix:DR
First Name:SHARON
Middle Name:LAMBERT
Last Name:RILEY
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1036 ETTA VESTA CIR
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30501-1154
Mailing Address - Country:US
Mailing Address - Phone:770-534-5695
Mailing Address - Fax:
Practice Address - Street 1:604 GREEN ST NE
Practice Address - Street 2:STE. 2
Practice Address - City:GAINESVILLE
Practice Address - State:GA
Practice Address - Zip Code:30501-3354
Practice Address - Country:US
Practice Address - Phone:770-287-0143
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA5112111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor