Provider Demographics
NPI:1558849448
Name:ATEN, RACHEL (DPT, PT)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:
Last Name:ATEN
Suffix:
Gender:F
Credentials:DPT, PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:524 S CRESCENT DR
Mailing Address - Street 2:
Mailing Address - City:KIRKWOOD
Mailing Address - State:MO
Mailing Address - Zip Code:63122-4629
Mailing Address - Country:US
Mailing Address - Phone:314-403-0492
Mailing Address - Fax:
Practice Address - Street 1:524 S CRESCENT DR
Practice Address - Street 2:
Practice Address - City:KIRKWOOD
Practice Address - State:MO
Practice Address - Zip Code:63122-4629
Practice Address - Country:US
Practice Address - Phone:314-403-0492
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-01
Last Update Date:2018-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2017027015225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist