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Organization
LCSS REHABILITATION, LLP
Active
Organization
LCSS REHABILITATION, LLP
Active
Other names
Vista Physical Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
CRAIG RETTKE PT (PRESIDENT)
(972) 529-3691
Entity
Organization
Contact information
Practice address
323 LAS COLINAS BLVD E, IRVING, TX 75039-5556
(972) 401-0300
(972) 257-0429
Mailing address
5100 W ELDORADO PKWY, #102-20LCPT, MCKINNEY, TX 75070-6309
(972) 401-0300
(972) 401-2800
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
635850002
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0018ES
BCBS
TX
Enumeration date
10/04/2005
Last updated
04/15/2022
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