Provider Demographics
NPI:1144606716
Name:CRANDALL, RACHEL GABRIELLE (PT, DPT)
Entity Type:Individual
Prefix:MRS
First Name:RACHEL
Middle Name:GABRIELLE
Last Name:CRANDALL
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:MS
Other - First Name:RACHEL
Other - Middle Name:GABRIELLE
Other - Last Name:MENDELSOHN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, DPT
Mailing Address - Street 1:347 W DAVIS BLVD
Mailing Address - Street 2:
Mailing Address - City:BOUNTIFUL
Mailing Address - State:UT
Mailing Address - Zip Code:84010-8047
Mailing Address - Country:US
Mailing Address - Phone:928-399-9864
Mailing Address - Fax:
Practice Address - Street 1:280 N MAIN ST FL 2
Practice Address - Street 2:
Practice Address - City:BOUNTIFUL
Practice Address - State:UT
Practice Address - Zip Code:84010-6136
Practice Address - Country:US
Practice Address - Phone:801-397-8736
Practice Address - Fax:801-397-8709
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-06
Last Update Date:2019-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP15765225100000X, 2251P0200X
UT9649385-24012251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist