Provider Demographics
NPI:1629126305
Name:PALLEX, RACHEL PALMY (LAT)
Entity Type:Individual
Prefix:MS
First Name:RACHEL
Middle Name:PALMY
Last Name:PALLEX
Suffix:
Gender:F
Credentials:LAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:327 N WESTHAVEN DR APT 104
Mailing Address - Street 2:
Mailing Address - City:OSHKOSH
Mailing Address - State:WI
Mailing Address - Zip Code:54904-5463
Mailing Address - Country:US
Mailing Address - Phone:920-748-1673
Mailing Address - Fax:920-748-4573
Practice Address - Street 1:933 NEWBURY ST
Practice Address - Street 2:
Practice Address - City:RIPON
Practice Address - State:WI
Practice Address - Zip Code:54971-1730
Practice Address - Country:US
Practice Address - Phone:920-748-9156
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI804-0392255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer