Provider Demographics
NPI:1225491905
Name:RIPPLE PHYSICAL THERAPY
Entity Type:Organization
Organization Name:RIPPLE PHYSICAL THERAPY
Other - Org Name:TERRAPIN PHYSICAL THERAPY INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:HEIDI
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:PAZZAGLIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:831-372-3579
Mailing Address - Street 1:PO BOX 222342
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:CA
Mailing Address - Zip Code:93922-2342
Mailing Address - Country:US
Mailing Address - Phone:831-372-3579
Mailing Address - Fax:831-372-3779
Practice Address - Street 1:21 UPPER RAGSDALE DR
Practice Address - Street 2:
Practice Address - City:MONTEREY
Practice Address - State:CA
Practice Address - Zip Code:93940-7831
Practice Address - Country:US
Practice Address - Phone:831-372-3579
Practice Address - Fax:831-372-3779
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TERRAPIN PHYSICAL THERAPY INC PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-03-31
Last Update Date:2017-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA2251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACG471AMedicare PIN