Provider Demographics
NPI:1043845209
Name:SMITH, RACHEL RAND (DPT)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:RAND
Last Name:SMITH
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 1:611 WATKINS CENTRE PKWY STE 300
Mailing Address - Street 2:
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:VA
Mailing Address - Zip Code:23114-4492
Mailing Address - Country:US
Mailing Address - Phone:804-325-8822
Mailing Address - Fax:804-794-3986
Practice Address - Street 1:611 WATKINS CENTRE PKWY STE 300
Practice Address - Street 2:
Practice Address - City:MIDLOTHIAN
Practice Address - State:VA
Practice Address - Zip Code:23114-4492
Practice Address - Country:US
Practice Address - Phone:804-325-8822
Practice Address - Fax:804-794-3986
Is Sole Proprietor?:No
Enumeration Date:2020-03-09
Last Update Date:2020-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305207468225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist