Provider Demographics
NPI:1750143483
Name:RIPLEY, CASSIEY LYNN (PTA)
Entity type:Individual
Prefix:
First Name:CASSIEY
Middle Name:LYNN
Last Name:RIPLEY
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7414 78TH ST
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79424-5208
Mailing Address - Country:US
Mailing Address - Phone:806-535-0975
Mailing Address - Fax:
Practice Address - Street 1:1717 NORFOLK AVE
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79416-6099
Practice Address - Country:US
Practice Address - Phone:806-281-6000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-29
Last Update Date:2024-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2040210225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant