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General NPI Number Information
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NPI Number | 1548450836
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Entity Type | Organization
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Legal Business Name | RIEKES CENTER PHYSICAL THERAPY
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Dates
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Enumeration Date | 08/01/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 3455 EDISON WAY
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City | MENLO PARK
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State | CA
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Zip | 94025
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Country | US
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Telephone | 650-298-3403
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Fax | 650-292-7762
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Provider Business Mailing Address
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Address Line | 3455 EDISON WAY
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City | MENLO PARK
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State | CA
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Zip | 94025
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Country | US
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Telephone | 650-298-3403
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Fax | 650-292-7762
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Authorized Official
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Title or Position | DIRECTOR OF PHYSICAL THERAPY
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Name | PAULA KRISTIN CHAN
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Credential | PT
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Telephone | 650-298-3415
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number |
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License Number State |
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