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NPI Code Detail

MEDICARE: DIANE K RITENOUR PT

MEDICARE: DIANE K RITENOUR 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
1225100000XPhysical Therapist02683IA
2225100000XPhysical TherapistIL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1982690947
Entity Type Code : Individual
Provider Name (Legal Business Name) : DIANE K RITENOUR PT
Provider Business Mailing Address
First Line : PO BOX 337
Second Line : 240 N BLUFF BLVD STE 101 CLINTON PHYSICAL THERAPY SVCS
City : CLINTON
State : IA
Zip : 52733-0337
Country : US
Telephone Number : 563-519-0242
Fax Number : 563-241-4353
Provider Business Practice Location Address
First Line : 915 13TH AVE N
Second Line : CLINTON PHYSICAL THERAPY
City : CLINTON
State : IA
Zip : 52732-5067
Country : US
Telephone Number : 563-243-7814
Fax Number : 563-243-2441
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/26/2005
Last Update Date : 07/08/2007

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