Provider Demographics
NPI:1457360216
Name:RIVERS, ERIC W (DC)
Entity Type:Individual
Prefix:DR
First Name:ERIC
Middle Name:W
Last Name:RIVERS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1427 W 86TH ST
Mailing Address - Street 2:#412
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46260-2103
Mailing Address - Country:US
Mailing Address - Phone:317-228-0023
Mailing Address - Fax:317-228-0662
Practice Address - Street 1:7780 MICHIGAN RD
Practice Address - Street 2:SUITE F
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46268-2374
Practice Address - Country:US
Practice Address - Phone:317-228-0023
Practice Address - Fax:317-228-0662
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN08001947A111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor