Organization
ROCK VALLEY PHYSICAL THERAPY CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RANDY E BOLDT PT (CFO)
(309) 743-2070
Entity
Organization
Contact information
Practice address
2635 LINCOLN WAY, SUITE C, CLINTON, IA 52732-7203
(563) 243-8321
(563) 241-4353
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
—
—
225X00000X
Occupational Therapist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0565937
—
IA
01
—
I1844
MEDICARE PTAN
IA
Enumeration date
09/16/2011
Last updated
09/16/2011
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