Provider Demographics
NPI:1417285396
Name:RISING, RACHEL JM (DC)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:JM
Last Name:RISING
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:RACHEL
Other - Middle Name:JEANNE MARIE
Other - Last Name:LACROIX
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:626 S FERGUSON AVE
Mailing Address - Street 2:SUITE 4
Mailing Address - City:BOZEMAN
Mailing Address - State:MT
Mailing Address - Zip Code:59718-6408
Mailing Address - Country:US
Mailing Address - Phone:406-555-1217
Mailing Address - Fax:406-551-2179
Practice Address - Street 1:626 S FERGUSON AVE
Practice Address - Street 2:SUITE 4
Practice Address - City:BOZEMAN
Practice Address - State:MT
Practice Address - Zip Code:59718-6408
Practice Address - Country:US
Practice Address - Phone:406-555-1217
Practice Address - Fax:406-551-2179
Is Sole Proprietor?:No
Enumeration Date:2009-12-03
Last Update Date:2013-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT1217111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
1417285396OtherNPI
1417285396OtherNPI