Provider Demographics
NPI:1083093876
Name:ABBOTT, RACHEL (DC)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:
Last Name:ABBOTT
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5016 FABLE AVE
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:VA
Mailing Address - Zip Code:23703-5203
Mailing Address - Country:US
Mailing Address - Phone:404-821-3828
Mailing Address - Fax:
Practice Address - Street 1:337 MAIN ST
Practice Address - Street 2:
Practice Address - City:SMITHFIELD
Practice Address - State:VA
Practice Address - Zip Code:23430-1346
Practice Address - Country:US
Practice Address - Phone:757-302-7033
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-05-26
Last Update Date:2017-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR009487111N00000X
VA0104557427111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor