Provider Demographics
NPI:1932764545
Name:RELIABLE PHYSICAL THERAPY, LLC
Entity Type:Organization
Organization Name:RELIABLE PHYSICAL THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:HERIBERTO
Authorized Official - Middle Name:I
Authorized Official - Last Name:MATA
Authorized Official - Suffix:
Authorized Official - Credentials:DPT, PT
Authorized Official - Phone:520-889-1328
Mailing Address - Street 1:537 N 6TH AVE
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85705-8371
Mailing Address - Country:US
Mailing Address - Phone:520-889-1328
Mailing Address - Fax:520-889-2355
Practice Address - Street 1:537 N 6TH AVE
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85705-8371
Practice Address - Country:US
Practice Address - Phone:520-889-1328
Practice Address - Fax:520-889-2355
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-08
Last Update Date:2019-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty