Provider Demographics
NPI:1275942120
Name:FORRESTER, RACHEL HADDOCK (PT)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:HADDOCK
Last Name:FORRESTER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:RACHEL
Other - Middle Name:
Other - Last Name:HADDOCK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:4360 FERGUSON DR STE 120
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45245-1683
Mailing Address - Country:US
Mailing Address - Phone:513-943-4400
Mailing Address - Fax:513-943-5323
Practice Address - Street 1:4360 FERGUSON DR STE 120
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45245-1683
Practice Address - Country:US
Practice Address - Phone:513-943-4400
Practice Address - Fax:513-943-5323
Is Sole Proprietor?:No
Enumeration Date:2014-08-05
Last Update Date:2022-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN10282225100000X
KY006446225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist