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
1905 INGERSOLL, SUITE 104, DES MOINES, IA 50309-3305
(515) 369-2306
(515) 369-2307
Mailing address
850 43RD AVENUE, SUITE 100, MOLINE, IL 61265-8401
(309) 743-2070
(309) 743-2073
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
IA
225X00000X
Occupational Therapist
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0565937
—
IA
Enumeration date
10/19/2010
Last updated
01/25/2011
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