Provider Demographics
NPI:1558027318
Name:CHALUPNIK, RACHEL D (CMT)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:D
Last Name:CHALUPNIK
Suffix:
Gender:F
Credentials:CMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18492 120TH ST SE
Mailing Address - Street 2:
Mailing Address - City:BIG LAKE
Mailing Address - State:MN
Mailing Address - Zip Code:55309-4891
Mailing Address - Country:US
Mailing Address - Phone:763-639-7792
Mailing Address - Fax:
Practice Address - Street 1:26250 2ND ST E
Practice Address - Street 2:
Practice Address - City:ZIMMERMAN
Practice Address - State:MN
Practice Address - Zip Code:55398-4602
Practice Address - Country:US
Practice Address - Phone:763-244-6842
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-16
Last Update Date:2021-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist