Individual
LISA C RIVES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, DPT, WCS, PRPC
Contact information
Practice address
3226 KIMBALL AVE, MANHATTAN, KS 66503-2157
(800) 974-4378
(630) 515-1536
Mailing address
24014 W RENWICK RD STE 206, PLAINFIELD, IL 60544-8711
(800) 974-4378
(630) 515-1536
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
11-08053
KS
225100000X
Physical Therapist
Primary
2305210475
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1710434642
MEDICAID QMB ONLY
VA
01
—
C05954
MEDICARE GROUP PTAN
VA
Enumeration date
09/08/2016
Last updated
01/20/2026
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