Provider Demographics
NPI:1659527091
Name:RETTIG, LINDA FOX (P T)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:FOX
Last Name:RETTIG
Suffix:
Gender:F
Credentials:P T
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 ALMA DRIVE
Mailing Address - Street 2:SUITE 135
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75075-8807
Mailing Address - Country:US
Mailing Address - Phone:972-424-5840
Mailing Address - Fax:
Practice Address - Street 1:700 ALMA DR
Practice Address - Street 2:SUITE 135
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75075-8807
Practice Address - Country:US
Practice Address - Phone:972-424-5840
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-18
Last Update Date:2008-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1103570225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist