Provider Demographics
NPI:1275261224
Name:RALLY REHAB AND WELLNESS LLC
Entity Type:Organization
Organization Name:RALLY REHAB AND WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / PHYSICAL THERAPIST
Authorized Official - Prefix:DR
Authorized Official - First Name:DOMINIQUE
Authorized Official - Middle Name:
Authorized Official - Last Name:FRENCH
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:847-815-3038
Mailing Address - Street 1:2147 CAMINO DEL SOL
Mailing Address - Street 2:
Mailing Address - City:ALAMOGORDO
Mailing Address - State:NM
Mailing Address - Zip Code:88310-7857
Mailing Address - Country:US
Mailing Address - Phone:847-815-3038
Mailing Address - Fax:
Practice Address - Street 1:2147 CAMINO DEL SOL
Practice Address - Street 2:
Practice Address - City:ALAMOGORDO
Practice Address - State:NM
Practice Address - Zip Code:88310-7857
Practice Address - Country:US
Practice Address - Phone:847-815-3038
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-09
Last Update Date:2022-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy