Provider Demographics
NPI:1306860903
Name:RALLY PHYSICAL THERAPY P S
Entity type:Organization
Organization Name:RALLY PHYSICAL THERAPY P S
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHRISTIE
Authorized Official - Middle Name:EILEEN
Authorized Official - Last Name:CONNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:253-531-4100
Mailing Address - Street 1:201 160TH ST S STE 301
Mailing Address - Street 2:
Mailing Address - City:SPANAWAY
Mailing Address - State:WA
Mailing Address - Zip Code:98387-8508
Mailing Address - Country:US
Mailing Address - Phone:253-531-4100
Mailing Address - Fax:253-531-3795
Practice Address - Street 1:201 160TH ST S STE 301
Practice Address - Street 2:
Practice Address - City:SPANAWAY
Practice Address - State:WA
Practice Address - Zip Code:98387-8508
Practice Address - Country:US
Practice Address - Phone:253-531-4100
Practice Address - Fax:253-531-3795
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-27
Last Update Date:2010-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty