Provider Demographics
NPI:1912175647
Name:RILEY, JAMES (OTR, CHT)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:
Last Name:RILEY
Suffix:
Gender:M
Credentials:OTR, CHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22401 FOSTER WINTER DRIVE
Mailing Address - Street 2:2ND FLOOR OUTPATIENT THERAPY
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48075
Mailing Address - Country:US
Mailing Address - Phone:248-423-5123
Mailing Address - Fax:248-423-5125
Practice Address - Street 1:22401 FOSTER WINTER DRIVE
Practice Address - Street 2:2ND FLOOR OUTPATIENT THERAPY
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48075
Practice Address - Country:US
Practice Address - Phone:248-423-5123
Practice Address - Fax:248-423-5125
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-15
Last Update Date:2008-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5201004080225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand