Provider Demographics
NPI:1104824267
Name:RIKE PHYSICAL THERAPY LLC
Entity Type:Organization
Organization Name:RIKE PHYSICAL THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MISS
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:B
Authorized Official - Last Name:SCRUGGS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-661-7453
Mailing Address - Street 1:11000 N SCOTTSDALE RD
Mailing Address - Street 2:STE 130
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85254-6130
Mailing Address - Country:US
Mailing Address - Phone:480-661-7453
Mailing Address - Fax:480-661-7454
Practice Address - Street 1:11000 N SCOTTSDALE RD
Practice Address - Street 2:STE 130
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85254-6130
Practice Address - Country:US
Practice Address - Phone:480-661-7453
Practice Address - Fax:480-661-7454
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ5631225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ81234Medicare ID - Type UnspecifiedPHYSICAL THERAPY GROUP ID
AZ81236Medicare ID - Type UnspecifiedKARENS ID #