Individual
MS. LISA RIEDLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
3351 EL CAMINO REAL, SUITE 180, ATHERTON, CA 94027-3811
(650) 365-8350
(650) 365-8353
Mailing address
3351 EL CAMINO REAL, SUITE 180, ATHERTON, CA 94027-3811
(650) 365-8350
(650) 365-8353
Taxonomy
Speciality
Code
Description
License number
State
2251S0007X
Sports Physical Therapist
Primary
PT17939
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PT17939
PT LICENSE
CA
Enumeration date
03/26/2007
Last updated
07/08/2007
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