Provider Demographics
NPI:1700551215
Name:BRANSTETER, RILEY (DC)
Entity Type:Individual
Prefix:DR
First Name:RILEY
Middle Name:
Last Name:BRANSTETER
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 1:18525 SUTTER BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:MORGAN HILL
Mailing Address - State:CA
Mailing Address - Zip Code:95037-2899
Mailing Address - Country:US
Mailing Address - Phone:408-779-3565
Mailing Address - Fax:
Practice Address - Street 1:18525 SUTTER BLVD STE 200
Practice Address - Street 2:
Practice Address - City:MORGAN HILL
Practice Address - State:CA
Practice Address - Zip Code:95037-2899
Practice Address - Country:US
Practice Address - Phone:408-779-3565
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-16
Last Update Date:2021-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC36139111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor