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General NPI Number Information
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NPI Number | 1306029095
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Entity Type | Organization
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Legal Business Name | RICK ROTHER, P.T., P.C.
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Dates
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Enumeration Date | 12/17/2007
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Last Update Date | 12/17/2007
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Provider Practice Location Address
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Address Line | 411 E BROADWAY
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City | COLUMBIA
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State | MO
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Zip | 65201-4437
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Country | US
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Telephone | 573-886-7411
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Fax | 573-443-7246
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Provider Business Mailing Address
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Address Line | 411 E BROADWAY
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City | COLUMBIA
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State | MO
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Zip | 65201-4437
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Country | US
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Telephone | 573-886-7411
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Fax | 573-443-7246
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Authorized Official
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Title or Position | PT/OWNER
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Name | MR. RICK J ROTHER JR.
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Credential | PT
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Telephone | 573-886-7411
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 00722
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License Number State | MO
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