Provider Demographics
NPI:1326362088
Name:ROCKLEIN PHYSICAL THERAPY, PLLC
Entity Type:Organization
Organization Name:ROCKLEIN PHYSICAL THERAPY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:BRADLEY
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:ROCKLEIN
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:518-928-8103
Mailing Address - Street 1:163 DELAWARE AVE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:DELMAR
Mailing Address - State:NY
Mailing Address - Zip Code:12054-1313
Mailing Address - Country:US
Mailing Address - Phone:518-928-8103
Mailing Address - Fax:
Practice Address - Street 1:163 DELAWARE AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:DELMAR
Practice Address - State:NY
Practice Address - Zip Code:12054-1313
Practice Address - Country:US
Practice Address - Phone:518-928-8103
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-23
Last Update Date:2010-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy