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NPI Code Detail

MEDICARE: MRS. KELLIE MAUREEN RIZZO MSPT

MEDICARE: MRS. KELLIE MAUREEN RIZZO MSPT
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
1225100000XPhysical Therapist027470-1NY
2225100000XPhysical Therapist

General Provider Information

NPI Number : 1437307840
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. KELLIE MAUREEN RIZZO MSPT
Provider Business Mailing Address
First Line : 2350 OAKDALE BLVD
Second Line :
City : CORALVILLE
State : IA
Zip : 52241-9702
Country : US
Telephone Number : 319-351-5437
Fax Number : 319-351-5432
Provider Business Practice Location Address
First Line : 2350 OAKDALE BLVD
Second Line :
City : CORALVILLE
State : IA
Zip : 52241-9702
Country : US
Telephone Number : 319-351-5437
Fax Number : 319-351-5432
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/28/2008
Last Update Date : 01/03/2018

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