Provider Demographics
NPI:1679858195
Name:ROCK SOLID ATHLETICS & REHAB
Entity Type:Organization
Organization Name:ROCK SOLID ATHLETICS & REHAB
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:VICKI
Authorized Official - Middle Name:JEAN CUTTING
Authorized Official - Last Name:SCHAEFER
Authorized Official - Suffix:
Authorized Official - Credentials:ATC, MA, PT
Authorized Official - Phone:530-409-8315
Mailing Address - Street 1:1550 OLD RANCH RD
Mailing Address - Street 2:
Mailing Address - City:PLACERVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95667-8929
Mailing Address - Country:US
Mailing Address - Phone:530-409-8315
Mailing Address - Fax:530-621-2392
Practice Address - Street 1:1550 OLD RANCH RD
Practice Address - Street 2:
Practice Address - City:PLACERVILLE
Practice Address - State:CA
Practice Address - Zip Code:95667-8929
Practice Address - Country:US
Practice Address - Phone:530-409-8315
Practice Address - Fax:530-621-2392
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-16
Last Update Date:2011-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center