Provider Demographics
NPI:1659712651
Name:RIEHLMAN, JENAE MARIE (MPT)
Entity Type:Individual
Prefix:
First Name:JENAE
Middle Name:MARIE
Last Name:RIEHLMAN
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:555 E TACHEVAH DR
Mailing Address - Street 2:BLDG 1 E SUITE 201
Mailing Address - City:PALM SPRINGS
Mailing Address - State:CA
Mailing Address - Zip Code:92262-5750
Mailing Address - Country:US
Mailing Address - Phone:760-778-7150
Mailing Address - Fax:760-778-7180
Practice Address - Street 1:81557 DOCTOR CARREON BLVD
Practice Address - Street 2:SUITE C8
Practice Address - City:INDIO
Practice Address - State:CA
Practice Address - Zip Code:92201-5517
Practice Address - Country:US
Practice Address - Phone:760-775-5511
Practice Address - Fax:760-775-5521
Is Sole Proprietor?:No
Enumeration Date:2013-07-08
Last Update Date:2013-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT40191225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPT40191OtherPT LICENSE