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General NPI Number Information
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NPI Number | 1376857730
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Entity Type | Organization
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Legal Business Name | RCR THERAPY
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Dates
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Enumeration Date | 07/28/2010
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Last Update Date | 07/28/2010
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Provider Practice Location Address
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Address Line | 2163 E BASELINE RD SUITE 105
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City | TEMPE
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State | AZ
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Zip | 85283-1541
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Country | US
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Telephone | 480-775-3503
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Fax | 480-775-3508
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Provider Business Mailing Address
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Address Line | 2163 E BASELINE RD SUITE 105
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City | TEMPE
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State | AZ
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Zip | 85283-1541
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Country | US
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Telephone | 480-775-3503
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Fax | 480-775-3508
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Authorized Official
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Title or Position | CHIEF TREATING PHYSICIAN
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Name | DR. PAUL ANDREW RICHETTO
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Credential | D.C.
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Telephone | 480-775-3503
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | 4562PT
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License Number State | AZ
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