| Organization Name: | RALLYSPORT |
| NPI Number: | 1447528922 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | ERIC MCILROY (OWNER) |
| Mailing Address: | 11 Oak Creek Dr Suite E Kaufman |
| State: | TX US |
| Postal Code: | 751423011 |
| Phone Number: | 9729321401 |
| Fax Number: | 9729321404 |
| NPI Enumeration Date: | 12/12/2011 |
| NPI Last Update Date: | 02/24/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP2000X |
| License Number: | 671590000 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TX |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Physical Therapy |
| Taxonomy Definition: | |