Basic Information
| Provider Information | |||||||||
| NPI: | 1568741247 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | RYBAK | ||||||||
| FirstName: | ALISON | ||||||||
| MiddleName: | COFER | ||||||||
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| Credential: | PT | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 5584 | ||||||||
| Address2: | |||||||||
| City: | FRISCO | ||||||||
| State: | CO | ||||||||
| PostalCode: | 804435584 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 358 BLUE RIVER PARKWAY | ||||||||
| Address2: | SUITE G | ||||||||
| City: | SILVERTHORNE | ||||||||
| State: | CO | ||||||||
| PostalCode: | 80498 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9703068609 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/11/2011 | ||||||||
| LastUpdateDate: | 12/31/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 10108 | CO | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.