Provider Demographics
NPI:1144785676
Name:BOWLING, RACHEL LYNN (DT)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:LYNN
Last Name:BOWLING
Suffix:
Gender:F
Credentials:DT
Other - Prefix:
Other - First Name:RACHEL
Other - Middle Name:
Other - Last Name:SCANTLIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2609 GLENN HENDREN DR STE G100
Mailing Address - Street 2:
Mailing Address - City:LIBERTY
Mailing Address - State:MO
Mailing Address - Zip Code:64068-3313
Mailing Address - Country:US
Mailing Address - Phone:816-479-4793
Mailing Address - Fax:881-647-9479
Practice Address - Street 1:2555 NORTERRE CIR
Practice Address - Street 2:
Practice Address - City:LIBERTY
Practice Address - State:MO
Practice Address - Zip Code:64068-3412
Practice Address - Country:US
Practice Address - Phone:816-463-8849
Practice Address - Fax:816-481-8781
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-08
Last Update Date:2019-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2018038639225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist