Provider Demographics
NPI:1518235084
Name:SUMMIT KIDS PHYSICAL THERAPY, LLC
Entity Type:Organization
Organization Name:SUMMIT KIDS PHYSICAL THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:ANN
Authorized Official - Middle Name:
Authorized Official - Last Name:RIPLEY
Authorized Official - Suffix:
Authorized Official - Credentials:MS, PT
Authorized Official - Phone:949-201-9333
Mailing Address - Street 1:5880 LASSO PL
Mailing Address - Street 2:
Mailing Address - City:PARKER
Mailing Address - State:CO
Mailing Address - Zip Code:80134-5221
Mailing Address - Country:US
Mailing Address - Phone:949-201-9333
Mailing Address - Fax:720-255-2099
Practice Address - Street 1:5880 LASSO PL
Practice Address - Street 2:
Practice Address - City:PARKER
Practice Address - State:CO
Practice Address - Zip Code:80134-5221
Practice Address - Country:US
Practice Address - Phone:949-201-9333
Practice Address - Fax:720-255-2099
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-12
Last Update Date:2011-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO110022251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatricsGroup - Single Specialty