Provider Demographics
NPI:1811995764
Name:RIPPEL, REBECCA S (PT)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:S
Last Name:RIPPEL
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 1:204 PIPE CREEK LN
Mailing Address - Street 2:
Mailing Address - City:GEORGETOWN
Mailing Address - State:TX
Mailing Address - Zip Code:78633-5444
Mailing Address - Country:US
Mailing Address - Phone:505-715-0477
Mailing Address - Fax:
Practice Address - Street 1:204 PIPE CREEK LN
Practice Address - Street 2:
Practice Address - City:GEORGETOWN
Practice Address - State:TX
Practice Address - Zip Code:78633-5444
Practice Address - Country:US
Practice Address - Phone:505-715-0477
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-07-13
Last Update Date:2012-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX12051502251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
R5983Medicare ID - Type Unspecified