Provider Demographics
NPI:1952758831
Name:RAINEY PAIN & PERFORMANCE, P.C.
Entity Type:Organization
Organization Name:RAINEY PAIN & PERFORMANCE, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NICHOLAS
Authorized Official - Middle Name:
Authorized Official - Last Name:RAINEY
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:520-955-1820
Mailing Address - Street 1:966 E FRY BLVD
Mailing Address - Street 2:
Mailing Address - City:SIERRA VISTA
Mailing Address - State:AZ
Mailing Address - Zip Code:85635-2640
Mailing Address - Country:US
Mailing Address - Phone:520-955-1820
Mailing Address - Fax:
Practice Address - Street 1:966 E FRY BLVD
Practice Address - Street 2:
Practice Address - City:SIERRA VISTA
Practice Address - State:AZ
Practice Address - Zip Code:85635-2640
Practice Address - Country:US
Practice Address - Phone:520-955-1820
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-19
Last Update Date:2024-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ11801261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy