MEDICARE: LISA RIEPE PT

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	225100000X	Physical Therapist	PT017324	PA
2	225100000X	Physical Therapist	PTL0013043	CO

General Provider Information

NPI Number	:	1841302098
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LISA RIEPE PT

Provider Business Mailing Address
First Line	:	3705 STARRY NIGHT LOOP
Second Line	:
City	:	CASTLE ROCK
State	:	CO
Zip	:	80109-3728
Country	:	US
Telephone Number	:	267-261-8399
Fax Number	:

Provider Business Practice Location Address
First Line	:	3705 STARRY NIGHT LOOP
Second Line	:
City	:	CASTLE ROCK
State	:	CO
Zip	:	80109-3728
Country	:	US
Telephone Number	:	267-261-8399
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/31/2006
Last Update Date	:	08/23/2024

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Directions to “ LISA RIEPE PT” Practice Location

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