Organization
ALLEN SPINE & SPORTSCARE, LLP
Active
Other names
Vista Physical Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
CRAIG RETTKE (PARTNER)
(972) 529-3691
Entity
Organization
Contact information
Practice address
1101 RAINTREE CIR, SUITE 150, ALLEN, TX 75013-4922
(214) 509-0029
(214) 509-0070
Mailing address
5100 W ELDORADO PKWY, #102-20ASSC, MCKINNEY, TX 75070-6309
(214) 509-0029
(214) 509-0070
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
635850004
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0023KX
BCBS
TX
Enumeration date
10/04/2005
Last updated
04/14/2022
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