Provider Demographics
NPI:1275914962
Name:WOOD, RACHEL M (DPT)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:M
Last Name:WOOD
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1155 WENTZVILLE PKWY STE 123
Mailing Address - Street 2:
Mailing Address - City:WENTZVILLE
Mailing Address - State:MO
Mailing Address - Zip Code:63385-3476
Mailing Address - Country:US
Mailing Address - Phone:636-332-1313
Mailing Address - Fax:636-332-2929
Practice Address - Street 1:1155 WENTZVILLE PKWY STE 123
Practice Address - Street 2:
Practice Address - City:WENTZVILLE
Practice Address - State:MO
Practice Address - Zip Code:63385-3476
Practice Address - Country:US
Practice Address - Phone:636-332-1313
Practice Address - Fax:636-332-2929
Is Sole Proprietor?:No
Enumeration Date:2015-06-18
Last Update Date:2015-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2015027153225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist