Provider Demographics
NPI:1083159990
Name:BYLES, RACHELLE (PTA, ATC, SCAT)
Entity Type:Individual
Prefix:MRS
First Name:RACHELLE
Middle Name:
Last Name:BYLES
Suffix:
Gender:F
Credentials:PTA, ATC, SCAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 HOLLOWAY ST APT 8322
Mailing Address - Street 2:
Mailing Address - City:SUMMERVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29486-8384
Mailing Address - Country:US
Mailing Address - Phone:828-371-9268
Mailing Address - Fax:
Practice Address - Street 1:601 HOLLOWAY ST APT 8322
Practice Address - Street 2:
Practice Address - City:SUMMERVILLE
Practice Address - State:SC
Practice Address - Zip Code:29486-8384
Practice Address - Country:US
Practice Address - Phone:828-371-9268
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-01-01
Last Update Date:2022-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCSC5303542255A2300X
SC4941225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer