Provider Demographics
NPI:1508002155
Name:ARMISTEAD, RACHELLE A (DPT)
Entity Type:Individual
Prefix:
First Name:RACHELLE
Middle Name:A
Last Name:ARMISTEAD
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:PO BOX 681478
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37068-1478
Mailing Address - Country:US
Mailing Address - Phone:615-591-6590
Mailing Address - Fax:615-591-6601
Practice Address - Street 1:1696 FAIRVIEW BLVD
Practice Address - Street 2:STE. 103
Practice Address - City:FAIRVIEW
Practice Address - State:TN
Practice Address - Zip Code:37062-5137
Practice Address - Country:US
Practice Address - Phone:615-799-1915
Practice Address - Fax:615-799-5928
Is Sole Proprietor?:No
Enumeration Date:2009-01-05
Last Update Date:2015-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN8053225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN0446631Medicaid
TN446631Medicare PIN