Provider Demographics
NPI:1477650331
Name:RAINBOW OF HEALTH PHYSICAL THERAPY, INC.
Entity Type:Organization
Organization Name:RAINBOW OF HEALTH PHYSICAL THERAPY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:COHEE
Authorized Official - Last Name:CALDERON
Authorized Official - Suffix:
Authorized Official - Credentials:PTA
Authorized Official - Phone:218-829-4231
Mailing Address - Street 1:224 N 5TH ST
Mailing Address - Street 2:
Mailing Address - City:BRAINERD
Mailing Address - State:MN
Mailing Address - Zip Code:56401-3348
Mailing Address - Country:US
Mailing Address - Phone:218-829-4231
Mailing Address - Fax:218-825-3855
Practice Address - Street 1:224 N 5TH ST
Practice Address - Street 2:
Practice Address - City:BRAINERD
Practice Address - State:MN
Practice Address - Zip Code:56401-3348
Practice Address - Country:US
Practice Address - Phone:218-829-4231
Practice Address - Fax:218-825-3855
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2014-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN5543225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty