Provider Demographics
NPI:1063468593
Name:CARTER, RACHEL (PT)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:
Last Name:CARTER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:RACHEL
Other - Middle Name:
Other - Last Name:GORHAM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:400 DIXIE LEE CENTER RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:KIMBALL
Mailing Address - State:TN
Mailing Address - Zip Code:37347-5672
Mailing Address - Country:US
Mailing Address - Phone:423-837-7536
Mailing Address - Fax:423-837-7538
Practice Address - Street 1:400 DIXIE LEE CENTER RD
Practice Address - Street 2:SUITE A
Practice Address - City:KIMBALL
Practice Address - State:TN
Practice Address - Zip Code:37347-5672
Practice Address - Country:US
Practice Address - Phone:423-837-7536
Practice Address - Fax:423-837-7538
Is Sole Proprietor?:No
Enumeration Date:2006-05-26
Last Update Date:2013-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3650078OtherMEDICARE