Provider Demographics
NPI:1013375260
Name:MEREDITH, RACHEL (DC)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:
Last Name:MEREDITH
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:RACHEL
Other - Middle Name:
Other - Last Name:YOUNG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:1640 MENTOR AVE
Mailing Address - Street 2:
Mailing Address - City:PAINESVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44077-1707
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1545 MENTOR AVE
Practice Address - Street 2:
Practice Address - City:PAINESVILLE
Practice Address - State:OH
Practice Address - Zip Code:44077-1706
Practice Address - Country:US
Practice Address - Phone:440-639-9171
Practice Address - Fax:440-579-0119
Is Sole Proprietor?:No
Enumeration Date:2016-02-03
Last Update Date:2020-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH4603111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor