Provider Demographics
NPI:1528364106
Name:PETERS, RACHEL LYNNE (DPT)
Entity Type:Individual
Prefix:MRS
First Name:RACHEL
Middle Name:LYNNE
Last Name:PETERS
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:105 MEADOW VIEW RD
Mailing Address - Street 2:SUITE 4
Mailing Address - City:BRISTOL
Mailing Address - State:TN
Mailing Address - Zip Code:37620-1725
Mailing Address - Country:US
Mailing Address - Phone:423-844-6935
Mailing Address - Fax:423-844-6937
Practice Address - Street 1:105 MEADOW VIEW RD
Practice Address - Street 2:SUITE 4
Practice Address - City:BRISTOL
Practice Address - State:TN
Practice Address - Zip Code:37620-1725
Practice Address - Country:US
Practice Address - Phone:423-844-6935
Practice Address - Fax:423-844-6937
Is Sole Proprietor?:No
Enumeration Date:2011-01-31
Last Update Date:2011-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNPT00000088712251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic