MEDICARE: RIBLETT THERAPY, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QP2000X	Physical Therapy Clinic/Center

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1992863179	OTHER	OR	INDIVIDUAL NPI

General Provider Information

NPI Number	:	1760017107
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RIBLETT THERAPY, LLC

Provider Business Mailing Address
First Line	:	4036 S 6TH ST STE 4
Second Line	:
City	:	KLAMATH FALLS
State	:	OR
Zip	:	97603-4750
Country	:	US
Telephone Number	:	541-883-3841
Fax Number	:	541-851-9365

Provider Business Practice Location Address
First Line	:	4036 S 6TH ST STE 4
Second Line	:
City	:	KLAMATH FALLS
State	:	OR
Zip	:	97603-4750
Country	:	US
Telephone Number	:	541-883-3841
Fax Number	:	541-851-9365

Authorized Official
Title or Position	:	OWNER
Name	:	MRS. CAROLINE E RIBLETT
Credential	:	PT, LMT
Telephone Number	:	541-883-3841

Provider Enumeration Date	:	03/05/2020
Last Update Date	:	03/05/2020

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Directions to “RIBLETT THERAPY, LLC ” Practice Location

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