Provider Demographics
NPI:1235488065
Name:PIOTROWSKI, RISA (PTA)
Entity type:Individual
Prefix:
First Name:RISA
Middle Name:
Last Name:PIOTROWSKI
Suffix:
Gender:
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4343 E 31ST PL
Mailing Address - Street 2:
Mailing Address - City:YUMA
Mailing Address - State:AZ
Mailing Address - Zip Code:85365-6553
Mailing Address - Country:US
Mailing Address - Phone:928-341-4544
Mailing Address - Fax:
Practice Address - Street 1:4343 E 31ST PL
Practice Address - Street 2:
Practice Address - City:YUMA
Practice Address - State:AZ
Practice Address - Zip Code:85365-6553
Practice Address - Country:US
Practice Address - Phone:928-341-4544
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-07
Last Update Date:2025-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2092291225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX111408402Medicaid
TX456554Medicare PIN