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Organization
ROCK VALLEY PHYSICAL THERAPY CENTER
Active
Organization
ROCK VALLEY PHYSICAL THERAPY CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RANDY E BOLDT P.T. (CFO)
(309) 743-2070
Entity
Organization
Contact information
Practice address
321 WASHINGTON ST, PROPHETSTOWN, IL 61277-1105
(815) 537-8899
(815) 537-8802
Mailing address
850 43RD AVE, SUITE 100, MOLINE, IL 61265-8401
(309) 743-2070
(309) 743-2073
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
IL
225X00000X
Occupational Therapist
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
555640
GROUP BILLING # FOR P.T.
IL
01
—
555650
GROUP BILLING # FOR O.T.
IL
Enumeration date
07/20/2009
Last updated
10/13/2010
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