MEDICARE: RILEY WHITCOMB DPT

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	119938	IA

General Provider Information

NPI Number	:	1841074739
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RILEY WHITCOMB DPT

Provider Business Mailing Address
First Line	:	2824 SUNSET CIR
Second Line	:
City	:	SIOUX CITY
State	:	IA
Zip	:	51104-4020
Country	:	US
Telephone Number	:	319-850-6639
Fax Number	:

Provider Business Practice Location Address
First Line	:	2800 PIERCE ST STE 110
Second Line	:
City	:	SIOUX CITY
State	:	IA
Zip	:	51104-3707
Country	:	US
Telephone Number	:	712-279-3754
Fax Number	:

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

Provider Enumeration Date	:	08/22/2023
Last Update Date	:	11/14/2023

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Directions to “ RILEY WHITCOMB DPT” Practice Location

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