Provider Demographics
NPI:1114441482
Name:MUMAW, RACHEL RAE (PT, DPT)
Entity Type:Individual
Prefix:MRS
First Name:RACHEL
Middle Name:RAE
Last Name:MUMAW
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6210 SAINT JOHNS RD
Mailing Address - Street 2:
Mailing Address - City:FLOYDS KNOBS
Mailing Address - State:IN
Mailing Address - Zip Code:47119-8516
Mailing Address - Country:US
Mailing Address - Phone:812-704-2285
Mailing Address - Fax:
Practice Address - Street 1:1002 SISTER BARBARA WAY
Practice Address - Street 2:
Practice Address - City:GEORGETOWN
Practice Address - State:IN
Practice Address - Zip Code:47122-8781
Practice Address - Country:US
Practice Address - Phone:812-940-5100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-28
Last Update Date:2024-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY007158225100000X
IN05012672A225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist