Provider Demographics
NPI:1386018869
Name:RIPPLES PHYSICAL THERAPY, LLC
Entity Type:Organization
Organization Name:RIPPLES PHYSICAL THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR OF PHYSICAL THERAPY/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KELLY
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:MACROW
Authorized Official - Suffix:
Authorized Official - Credentials:DPT, CWS
Authorized Official - Phone:406-396-3394
Mailing Address - Street 1:1267 QUARTER HORSE LN
Mailing Address - Street 2:
Mailing Address - City:KALISPELL
Mailing Address - State:MT
Mailing Address - Zip Code:59901-2514
Mailing Address - Country:US
Mailing Address - Phone:406-396-3394
Mailing Address - Fax:
Practice Address - Street 1:1267 QUARTER HORSE LN
Practice Address - Street 2:
Practice Address - City:KALISPELL
Practice Address - State:MT
Practice Address - Zip Code:59901-2514
Practice Address - Country:US
Practice Address - Phone:406-396-3394
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-19
Last Update Date:2015-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTPT-LIC-1936261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy