Provider Demographics
NPI:1275077190
Name:LONGBINE, RACHEL (MPT)
Entity Type:Individual
Prefix:MRS
First Name:RACHEL
Middle Name:
Last Name:LONGBINE
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:RACHEL
Other - Middle Name:
Other - Last Name:GREINER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:520 LINCOLN ST
Mailing Address - Street 2:
Mailing Address - City:AINSWORTH
Mailing Address - State:IA
Mailing Address - Zip Code:52201-9455
Mailing Address - Country:US
Mailing Address - Phone:319-657-2073
Mailing Address - Fax:
Practice Address - Street 1:4725 MERLE HAY RD STE 107
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50322-1983
Practice Address - Country:US
Practice Address - Phone:515-331-3190
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-12-12
Last Update Date:2016-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA03387225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist