Provider Demographics
NPI:1134797178
Name:RILEY, SIENNA WILLOW (PT)
Entity type:Individual
Prefix:
First Name:SIENNA
Middle Name:WILLOW
Last Name:RILEY
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 S PIERCE ST
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80226-2144
Mailing Address - Country:US
Mailing Address - Phone:530-277-3217
Mailing Address - Fax:
Practice Address - Street 1:155 S MADISON ST STE 303
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80209-3014
Practice Address - Country:US
Practice Address - Phone:303-388-1537
Practice Address - Fax:303-388-4470
Is Sole Proprietor?:No
Enumeration Date:2021-06-16
Last Update Date:2021-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPTL.0017714225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist