Provider Demographics
NPI:1548450836
Name:RIEKES CENTER PHYSICAL THERAPY
Entity type:Organization
Organization Name:RIEKES CENTER PHYSICAL THERAPY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF PHYSICAL THERAPY
Authorized Official - Prefix:
Authorized Official - First Name:PAULA
Authorized Official - Middle Name:KRISTIN
Authorized Official - Last Name:CHAN
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:650-298-3415
Mailing Address - Street 1:3455 EDISON WAY
Mailing Address - Street 2:
Mailing Address - City:MENLO PARK
Mailing Address - State:CA
Mailing Address - Zip Code:94025
Mailing Address - Country:US
Mailing Address - Phone:650-298-3403
Mailing Address - Fax:650-292-7762
Practice Address - Street 1:3455 EDISON WAY
Practice Address - Street 2:
Practice Address - City:MENLO PARK
Practice Address - State:CA
Practice Address - Zip Code:94025
Practice Address - Country:US
Practice Address - Phone:650-298-3403
Practice Address - Fax:650-292-7762
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Single Specialty