Provider Demographics
NPI:1548973605
Name:APPLEGATE, RILEY FAYE
Entity type:Individual
Prefix:
First Name:RILEY
Middle Name:FAYE
Last Name:APPLEGATE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:971 GATOR CT
Mailing Address - Street 2:
Mailing Address - City:FRUITA
Mailing Address - State:CO
Mailing Address - Zip Code:81521-8911
Mailing Address - Country:US
Mailing Address - Phone:970-216-1540
Mailing Address - Fax:
Practice Address - Street 1:741 W WILSHIRE CT
Practice Address - Street 2:
Practice Address - City:GRAND JUNCTION
Practice Address - State:CO
Practice Address - Zip Code:81506-1826
Practice Address - Country:US
Practice Address - Phone:970-245-1716
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-03
Last Update Date:2023-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor