Provider Demographics
NPI:1053409441
Name:RIDDLE, ANDREW W (DC)
Entity type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:W
Last Name:RIDDLE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:509 LAKEVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:DE
Mailing Address - Zip Code:19963-2917
Mailing Address - Country:US
Mailing Address - Phone:302-422-3100
Mailing Address - Fax:302-422-2900
Practice Address - Street 1:509 LAKEVIEW AVE
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:DE
Practice Address - Zip Code:19963-2917
Practice Address - Country:US
Practice Address - Phone:302-422-3100
Practice Address - Fax:302-422-2900
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2021-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEF1-0000522111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor