Provider Demographics
NPI:1033567508
Name:NEATHERY, RACHEL FOLLINGSTAD (PT, DPT)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:FOLLINGSTAD
Last Name:NEATHERY
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5801 CROSSLAKE PKWY
Mailing Address - Street 2:
Mailing Address - City:WACO
Mailing Address - State:TX
Mailing Address - Zip Code:76712-6948
Mailing Address - Country:US
Mailing Address - Phone:254-420-0056
Mailing Address - Fax:
Practice Address - Street 1:5801 CROSSLAKE PKWY
Practice Address - Street 2:
Practice Address - City:WACO
Practice Address - State:TX
Practice Address - Zip Code:76712-6948
Practice Address - Country:US
Practice Address - Phone:254-420-0056
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-25
Last Update Date:2016-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1249399225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist