MEDICARE: REDDICK PHYSICAL THERAPY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208100000X	Physical Medicine & Rehabilitation Physician	J9294	TX

General Provider Information

NPI Number	:	1730343906
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	REDDICK PHYSICAL THERAPY

Provider Business Mailing Address
First Line	:	2300 VALLEY VIEW LN
Second Line	:	SUITE 1025
City	:	IRVING
State	:	TX
Zip	:	75062-5056
Country	:	US
Telephone Number	:	214-441-3046
Fax Number	:	214-441-3056

Provider Business Practice Location Address
First Line	:	2300 VALLEY VIEW LN
Second Line	:	SUITE 1025
City	:	IRVING
State	:	TX
Zip	:	75062-5056
Country	:	US
Telephone Number	:	214-441-3046
Fax Number	:	214-441-3056

Authorized Official
Title or Position	:	PHYSICIAN/OWNER
Name	:	DR. SYBIL ROCHELLE REDDICK
Credential	:	M.D.
Telephone Number	:	214-441-3046

Provider Enumeration Date	:	07/16/2008
Last Update Date	:	07/16/2008

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Directions to “REDDICK PHYSICAL THERAPY ” Practice Location

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