Basic Information
| Provider Information | |||||||||
| NPI: | 1306860903 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | RALLY PHYSICAL THERAPY P S | ||||||||
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| OtherOrganizationName: | RALLY PHYSICAL THERAPY P S | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 201 160TH ST S STE 301 | ||||||||
| Address2: | |||||||||
| City: | SPANAWAY | ||||||||
| State: | WA | ||||||||
| PostalCode: | 983878508 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2535314100 | ||||||||
| FaxNumber: | 2535313795 | ||||||||
| Practice Location | |||||||||
| Address1: | 201 160TH ST S STE 301 | ||||||||
| Address2: | |||||||||
| City: | SPANAWAY | ||||||||
| State: | WA | ||||||||
| PostalCode: | 983878508 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2535314100 | ||||||||
| FaxNumber: | 2535313795 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/27/2006 | ||||||||
| LastUpdateDate: | 12/28/2010 | ||||||||
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| ProviderGenderCode: | |||||||||
| AuthorizedOfficialLastName: | CONNER | ||||||||
| AuthorizedOfficialFirstName: | CHRISTIE | ||||||||
| AuthorizedOfficialMiddleName: | EILEEN | ||||||||
| AuthorizedOfficialTitleorPosition: | OFFICE MANAGER | ||||||||
| AuthorizedOfficialTelephone: | 2535314100 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MRS. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | WA | Y | 193400000X SINGLE SPECIALTY GROUP | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.