MEDICARE: MARISSA K RIVERA 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	PT12150	NC

General Provider Information

NPI Number	:	1881771970
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARISSA K RIVERA PT

Provider Business Mailing Address
First Line	:	5813 LADY WAY
Second Line	:
City	:	HOPE MILLS
State	:	NC
Zip	:	28348-9394
Country	:	US
Telephone Number	:	910-789-2554
Fax Number	:

Provider Business Practice Location Address
First Line	:	3522 STURBRIDGE DR
Second Line	:
City	:	HOPE MILLS
State	:	NC
Zip	:	28348-2154
Country	:	US
Telephone Number	:	910-424-7200
Fax Number	:

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

Provider Enumeration Date	:	11/01/2006
Last Update Date	:	06/10/2026

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