Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251N0400X | Physical Therapist - Neurology | 872649 | DC |
NPI | 1215501986 |
---|---|
Provider Name | Jonathan Ripic |
First Address | Washington, DC 20010-2921 |
Second Address | Washington, DC 20010-2921 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/05/2021 |
Last Update Date | 18/05/2021 |