Organization
ROCK VALLEY PHYSICAL THERAPY CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RANDY E BOLDT (CFO)
(309) 743-2070
Entity
Organization
Contact information
Practice address
900 14TH ST, DE WITT, IA 52742-1004
(309) 743-2070
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
—
IA
225X00000X
Occupational Therapist
—
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0565937
—
IA
Enumeration date
05/15/2007
Last updated
08/04/2008
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