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Individual

MARISA LYNN RICKENBACH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MSPT

Contact information

Practice address
20261 E OCOTILLO RD, SUITE 110, QUEEN CREEK, AZ 85242-8806
(480) 677-2771
(480) 677-2768
Mailing address
4081 E SANTA FE LN, GILBERT, AZ 85297-8034
(480) 656-4808

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
40QA01208100
NJ
225100000X
Physical Therapist
Primary
7092
AZ
225100000X
Physical Therapist
PT017984
PA

Other

Enumeration date
10/06/2006
Last updated
06/03/2009
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