Provider Demographics
NPI:1598867376
Name:RIPP, PATRICK CHARLES (PT OCS CMPT)
Entity type:Individual
Prefix:MR
First Name:PATRICK
Middle Name:CHARLES
Last Name:RIPP
Suffix:
Gender:M
Credentials:PT OCS CMPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8701 N LOOP WAY
Mailing Address - Street 2:
Mailing Address - City:JUNEAU
Mailing Address - State:AK
Mailing Address - Zip Code:99801-9260
Mailing Address - Country:US
Mailing Address - Phone:907-789-1343
Mailing Address - Fax:
Practice Address - Street 1:641 W WILLOUGHBY AVE
Practice Address - Street 2:
Practice Address - City:JUNEAU
Practice Address - State:AK
Practice Address - Zip Code:99801-1731
Practice Address - Country:US
Practice Address - Phone:907-586-5951
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK6282251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic