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General NPI Number Information
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NPI Number | 1952758831
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Entity Type | Organization
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Legal Business Name | RAINEY PAIN & PERFORMANCE, P.C.
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Dates
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Enumeration Date | 05/19/2016
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Last Update Date | 01/05/2024
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Provider Practice Location Address
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Address Line | 966 E FRY BLVD
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City | SIERRA VISTA
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State | AZ
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Zip | 85635-2640
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Country | US
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Telephone | 520-955-1820
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Fax |
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Provider Business Mailing Address
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Address Line | 966 E FRY BLVD
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City | SIERRA VISTA
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State | AZ
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Zip | 85635-2640
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Country | US
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Telephone | 520-955-1820
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | NICHOLAS RAINEY
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Credential | PT
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Telephone | 520-955-1820
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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 | 11801
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License Number State | AZ
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