Provider Demographics
NPI:1437509056
Name:SOBCZAK, RACHEL ALLISON (DPT)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:ALLISON
Last Name:SOBCZAK
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 1:3310 LAKE ST NW
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:MN
Mailing Address - Zip Code:55901-7589
Mailing Address - Country:US
Mailing Address - Phone:507-581-3110
Mailing Address - Fax:
Practice Address - Street 1:625 SW RAMSEY AVE
Practice Address - Street 2:SUITE B
Practice Address - City:GRANTS PASS
Practice Address - State:OR
Practice Address - Zip Code:97527-5808
Practice Address - Country:US
Practice Address - Phone:541-476-1919
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-14
Last Update Date:2016-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR616492251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic