Provider Demographics
NPI:1003120221
Name:SATROM, RACHEL ELAINE (DPT)
Entity Type:Individual
Prefix:MRS
First Name:RACHEL
Middle Name:ELAINE
Last Name:SATROM
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:MS
Other - First Name:RACHEL
Other - Middle Name:ELAINE
Other - Last Name:DEWITT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:6700 FRANCE AVE S
Mailing Address - Street 2:SUITE 300
Mailing Address - City:EDINA
Mailing Address - State:MN
Mailing Address - Zip Code:55435-1902
Mailing Address - Country:US
Mailing Address - Phone:952-345-3000
Mailing Address - Fax:952-345-6789
Practice Address - Street 1:320 COON RAPIDS BLVD NW
Practice Address - Street 2:SUITE 200
Practice Address - City:COON RAPIDS
Practice Address - State:MN
Practice Address - Zip Code:55433-5639
Practice Address - Country:US
Practice Address - Phone:763-786-6900
Practice Address - Fax:763-786-6901
Is Sole Proprietor?:No
Enumeration Date:2010-07-29
Last Update Date:2014-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN8552225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist