Provider Demographics
NPI:1992863179
Name:RIBLETT, CAROLINE LOUISE (PT, LMT)
Entity Type:Individual
Prefix:MRS
First Name:CAROLINE
Middle Name:LOUISE
Last Name:RIBLETT
Suffix:
Gender:F
Credentials:PT, LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4036 S 6TH ST STE 4
Mailing Address - Street 2:
Mailing Address - City:KLAMATH FALLS
Mailing Address - State:OR
Mailing Address - Zip Code:97603-4750
Mailing Address - Country:US
Mailing Address - Phone:541-883-3841
Mailing Address - Fax:541-851-9365
Practice Address - Street 1:4036 S 6TH ST STE 4
Practice Address - Street 2:
Practice Address - City:KLAMATH FALLS
Practice Address - State:OR
Practice Address - Zip Code:97603-4750
Practice Address - Country:US
Practice Address - Phone:541-883-3841
Practice Address - Fax:541-851-9365
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-04
Last Update Date:2019-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR7355225700000X
OR1170225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR007394000OtherBCBS ID NUMBER