Organization
RALLY PHYSICAL THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CASEY KETELSEN (OWNER)
(309) 433-3273
Entity
Organization
Contact information
Practice address
19165 MEANDER WAY, BLOOMINGTON, IL 61705-5227
(309) 310-3158
Mailing address
19165 MEANDER WAY, BLOOMINGTON, IL 61705-5227
(309) 310-3158
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
070016508
IL
Other
Enumeration date
04/02/2014
Last updated
04/02/2014
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