Zack Riessen M.ED., ATC, LAT

NPI 1548675374 - Specialist/Technologist - 2255A2300X

NPI Details
NPI 1548675374
Gender Male
Enumeration Date 07/01/2014
Last Updated 12/08/2015
Entity Type Individual
Active Over 2 years ago
Practice Location
1002 DIAMOND RDG
#800
JEFFERSON CITY MO, 65109-6896, US
Phone (573) 761-9360
Fax
Business Location
1002 DIAMOND RDG
#800
JEFFERSON CITY MO, 65109-6896, US
Phone
Fax
Toxanomy
Taxonomy Code 2255A2300X
License State Missouri
License Number 2011026863
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According to our database, Zack Riessen M.ED., ATC, LAT NPI is 1548675374, taxonomy code is 2255A2300X and license number is 2011026863, license state is located at Missouri. Zack Riessen M.ED., ATC, LAT physically located at 1002 Diamond Rdg, Jefferson City MO, 65109-6896. NPI Number Zack Riessen M.ED., ATC, LAT has the Individual type.

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1548675374 NPI number is provided on an as is basis without warranty of any kind. 1548675374 is maintained by the National Plan & Provider Enumeration System. The contents of Zack Riessen M.ED., ATC, LAT are for informational purposes only.