Provider Demographics
NPI:1801616404
Name:CHERIAN, RIYA (PT, DPT)
Entity type:Individual
Prefix:
First Name:RIYA
Middle Name:
Last Name:CHERIAN
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1237 ROCKY BRANCH TRL
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30043-3855
Mailing Address - Country:US
Mailing Address - Phone:678-739-6269
Mailing Address - Fax:
Practice Address - Street 1:1237 ROCKY BRANCH TRL
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30043-3855
Practice Address - Country:US
Practice Address - Phone:678-739-6269
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-16
Last Update Date:2024-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT017405225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist