Provider Demographics
NPI:1497705404
Name:RYKE REHABILITATION LLC
Entity Type:Organization
Organization Name:RYKE REHABILITATION LLC
Other - Org Name:RYKE PHYSCIAL THERAPY & SPORTS MEDICINE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BUSINESS OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:DUSTIN
Authorized Official - Middle Name:ALLAN
Authorized Official - Last Name:MCARTHUR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-337-7953
Mailing Address - Street 1:3875 EAST SOUTHCROSS BLVD
Mailing Address - Street 2:SUITE B
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78222
Mailing Address - Country:US
Mailing Address - Phone:210-337-7953
Mailing Address - Fax:210-337-7966
Practice Address - Street 1:3875 EAST SOUTHCROSS BLVD
Practice Address - Street 2:SUITE B
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78222
Practice Address - Country:US
Practice Address - Phone:210-337-7953
Practice Address - Fax:210-337-7966
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-11
Last Update Date:2007-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
00974XMedicare ID - Type Unspecified