Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 11104 | AZ |
N | 2251S0007X | Physical Therapist - Sports | ||
N | 2251X0800X | Physical Therapist - Orthopedic |
NPI | 1083013718 |
---|---|
Provider Name | Jennifer Ribbens |
First Address | Phoenix, AZ 85044-6691 |
Second Address | Chandler, AZ 85248-3757 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/08/2014 |
Last Update Date | 15/09/2015 |