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General NPI Number Information
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NPI Number | 1780844316
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Entity Type | Organization
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Legal Business Name | RIDER WELLNESS & REHAB
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Dates
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Enumeration Date | 06/17/2008
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Last Update Date | 06/17/2008
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Provider Practice Location Address
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Address Line | 820 S ALMA DR 100
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City | ALLEN
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State | TX
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Zip | 75013-3808
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Country | US
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Telephone | 214-383-2641
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Fax | 214-383-9534
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Provider Business Mailing Address
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Address Line | 2338 CUESTA LN
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City | MCKINNEY
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State | TX
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Zip | 75070-3810
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Country | US
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Telephone | 214-383-2641
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Fax | 214-383-9534
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Authorized Official
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Title or Position | OWNER
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Name | DR. MICHAEL RIDER
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Credential | D.C.
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Telephone | 214-383-2641
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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 | 1154464709
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License Number State | TX
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