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General NPI Number Information
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NPI Number | 1437867421
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Entity Type | Organization
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Legal Business Name | RTG REHAB PLLC
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Dates
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Enumeration Date | 11/09/2022
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Last Update Date | 11/09/2022
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Provider Practice Location Address
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Address Line | 18252 FM 1488 RD STE 130
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City | MAGNOLIA
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State | TX
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Zip | 77354-4527
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Country | US
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Telephone | 281-356-8645
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Fax | 281-356-8447
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Provider Business Mailing Address
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Address Line | 18252 FM 1488 RD STE 130
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City | MAGNOLIA
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State | TX
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Zip | 77354-4527
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Country | US
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Telephone | 281-356-8645
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Fax | 281-356-8447
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Authorized Official
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Title or Position | OWNER
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Name | RUSSELL T GREEN
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Credential | DPT
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Telephone | 281-356-8645
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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 |
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License Number State |
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