Provider Demographics
NPI:1164962890
Name:SCHMIDT, RACHEL MARIE (ATC)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:MARIE
Last Name:SCHMIDT
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7912 DELLWOOD DR
Mailing Address - Street 2:
Mailing Address - City:URBANDALE
Mailing Address - State:IA
Mailing Address - Zip Code:50322-4409
Mailing Address - Country:US
Mailing Address - Phone:515-371-8163
Mailing Address - Fax:
Practice Address - Street 1:2700 COLLEGE RD
Practice Address - Street 2:
Practice Address - City:COUNCIL BLUFFS
Practice Address - State:IA
Practice Address - Zip Code:51503-1057
Practice Address - Country:US
Practice Address - Phone:515-371-8163
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-02-28
Last Update Date:2017-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA0835962081S0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081S0010XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationSports Medicine