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NPI Code Detail

MEDICARE: ROCK VALLEY PHYSICAL THERAPY CENTER

MEDICARE: ROCK VALLEY PHYSICAL THERAPY CENTER
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
1225X00000XOccupational Therapist
2225100000XPhysical Therapist

General Provider Information

NPI Number : 1891171047
Entity Type Code : Organization
Provider Name (Legal Business Name) : ROCK VALLEY PHYSICAL THERAPY CENTER
Provider Business Mailing Address
First Line : 850 43RD AVE
Second Line : STE. 100
City : MOLINE
State : IL
Zip : 61265-8401
Country : US
Telephone Number : 309-743-2070
Fax Number : 309-743-2073
Provider Business Practice Location Address
First Line : 9901 N KNOXVILLE AVE STE D
Second Line :
City : PEORIA
State : IL
Zip : 61615-1433
Country : US
Telephone Number : 309-243-1989
Fax Number : 309-243-8138
Authorized Official
Title or Position : PT, CFO
Name : RANDALL E BOLDT
Credential : PT
Telephone Number : 309-743-2070
Provider Enumeration Date : 08/10/2015
Last Update Date : 02/11/2021

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Directions to “ROCK VALLEY PHYSICAL THERAPY CENTER ” Practice Location

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