Provider Demographics
NPI:1376857730
Name:RCR THERAPY
Entity Type:Organization
Organization Name:RCR THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF TREATING PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:ANDREW
Authorized Official - Last Name:RICHETTO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:480-775-3503
Mailing Address - Street 1:2163 E BASELINE RD
Mailing Address - Street 2:SUITE 105
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85283-1541
Mailing Address - Country:US
Mailing Address - Phone:480-775-3503
Mailing Address - Fax:480-775-3508
Practice Address - Street 1:2163 E BASELINE RD
Practice Address - Street 2:SUITE 105
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85283-1541
Practice Address - Country:US
Practice Address - Phone:480-775-3503
Practice Address - Fax:480-775-3508
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:RICHETTO CHIROPRACTIC AND REHABILITATION, PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-07-28
Last Update Date:2010-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ4562PT261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy