Provider Demographics
NPI:1043776651
Name:KLIMETZ, RACHEL (DPT)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:
Last Name:KLIMETZ
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:435 BLAIN RD
Mailing Address - Street 2:
Mailing Address - City:ROSSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38066-3401
Mailing Address - Country:US
Mailing Address - Phone:901-355-0849
Mailing Address - Fax:
Practice Address - Street 1:1501 HOLIDAY DR
Practice Address - Street 2:
Practice Address - City:SULPHUR SPRINGS
Practice Address - State:TX
Practice Address - Zip Code:75482-4707
Practice Address - Country:US
Practice Address - Phone:903-335-8727
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-19
Last Update Date:2019-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1313188225100000X
COPTL0013598225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist