Organization Name: | RIVERSIDE PHYSICAL THERAPY, LLC |
NPI Number: | 1174868145 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | CHRISTY PETERSON (PHYSICAL THERAPIST) |
Mailing Address: | 47581 815th Rd Ord |
State: | NE US |
Postal Code: | 688625362 |
Phone Number: | 3087284070 |
Fax Number: | 8664114048 |
NPI Enumeration Date: | 12/03/2012 |
NPI Last Update Date: | 08/12/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QP2000X |
License Number: | 670 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NE |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Physical Therapy |
Taxonomy Definition: |