Provider Demographics
NPI:1942532718
Name:RIO CHIROPRACTIC INC.
Entity type:Organization
Organization Name:RIO CHIROPRACTIC INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ELISE
Authorized Official - Middle Name:APRIL
Authorized Official - Last Name:RIO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:909-947-7777
Mailing Address - Street 1:1525 S GROVE AVE
Mailing Address - Street 2:SUITE #3
Mailing Address - City:ONTARIO
Mailing Address - State:CA
Mailing Address - Zip Code:91761-4586
Mailing Address - Country:US
Mailing Address - Phone:909-947-7777
Mailing Address - Fax:909-947-7703
Practice Address - Street 1:1525 S GROVE AVE
Practice Address - Street 2:SUITE #3
Practice Address - City:ONTARIO
Practice Address - State:CA
Practice Address - Zip Code:91761-4586
Practice Address - Country:US
Practice Address - Phone:909-947-7777
Practice Address - Fax:909-947-7703
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-04
Last Update Date:2010-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA23098111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC0230980Medicare PIN