Provider Demographics
NPI:1730579913
Name:VISTA REHAB PARTNERS LP
Entity type:Organization
Organization Name:VISTA REHAB PARTNERS LP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:
Authorized Official - Last Name:RETTKE
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:972-529-3691
Mailing Address - Street 1:5100 ELDORADO PKWY # 102-20R
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75070-6510
Mailing Address - Country:US
Mailing Address - Phone:214-383-9930
Mailing Address - Fax:214-383-9929
Practice Address - Street 1:435 W PRESIDENT GEORGE BUSH HWY # 100
Practice Address - Street 2:
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75080-1144
Practice Address - Country:US
Practice Address - Phone:214-383-9930
Practice Address - Fax:214-383-9929
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-27
Last Update Date:2022-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty