Provider Demographics
NPI:1871806760
Name:RIGGS, MINECA M (PT)
Entity type:Individual
Prefix:
First Name:MINECA
Middle Name:M
Last Name:RIGGS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:MINECA
Other - Middle Name:M
Other - Last Name:RIGGS-FLORES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:140 BOARDWALK DR UNIT A
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80525-3153
Mailing Address - Country:US
Mailing Address - Phone:970-223-8293
Mailing Address - Fax:970-223-8219
Practice Address - Street 1:140 BOARDWALK DR UNIT A
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80525-3153
Practice Address - Country:US
Practice Address - Phone:970-223-8293
Practice Address - Fax:970-223-8219
Is Sole Proprietor?:No
Enumeration Date:2010-07-20
Last Update Date:2013-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR6234225100000X
CO11676225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR6234OtherLICENSE NUMBER