Provider Demographics
NPI:1831476092
Name:R & T PHYSICAL THERAPY LLC
Entity Type:Organization
Organization Name:R & T PHYSICAL THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PT
Authorized Official - Prefix:
Authorized Official - First Name:RHONDA
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:SUTTON-FORSTON
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:618-841-3702
Mailing Address - Street 1:PO BOX 451
Mailing Address - Street 2:112 SOUTH DIVISION ST
Mailing Address - City:NORRIS CITY
Mailing Address - State:IL
Mailing Address - Zip Code:62869
Mailing Address - Country:US
Mailing Address - Phone:618-841-3702
Mailing Address - Fax:
Practice Address - Street 1:112 SOUTH DIVISION ST
Practice Address - Street 2:
Practice Address - City:NORRIS CITY
Practice Address - State:IL
Practice Address - Zip Code:62869
Practice Address - Country:US
Practice Address - Phone:618-841-3702
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-15
Last Update Date:2012-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070.016618225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty