Provider Demographics
NPI:1164548418
Name:FAILE, RACHEL (LPT)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:
Last Name:FAILE
Suffix:
Gender:F
Credentials:LPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2315 COLISEUM DR
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27106-5801
Mailing Address - Country:US
Mailing Address - Phone:336-727-2440
Mailing Address - Fax:336-727-2873
Practice Address - Street 1:2315 COLISEUM DR
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27106-5801
Practice Address - Country:US
Practice Address - Phone:336-727-2440
Practice Address - Fax:336-727-2873
Is Sole Proprietor?:No
Enumeration Date:2007-03-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC47392251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7211834Medicaid