Provider Demographics
NPI:1972571164
Name:RIVOIRE, STEPHEN DAVID (MS,PT)
Entity type:Individual
Prefix:
First Name:STEPHEN
Middle Name:DAVID
Last Name:RIVOIRE
Suffix:
Gender:M
Credentials:MS,PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4674 SNOW MESA DR
Mailing Address - Street 2:SUITE 140
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80528-8615
Mailing Address - Country:US
Mailing Address - Phone:970-266-3850
Mailing Address - Fax:970-266-3855
Practice Address - Street 1:4674 SNOW MESA DR
Practice Address - Street 2:SUITE 140
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80528-8615
Practice Address - Country:US
Practice Address - Phone:970-266-3850
Practice Address - Fax:970-266-3855
Is Sole Proprietor?:No
Enumeration Date:2006-03-14
Last Update Date:2007-11-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CO5187225100000X, 2251N0400X, 2251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251N0400XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistNeurology
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic