Provider Demographics
NPI:1689098998
Name:THOR, RACHEL MARIE (DPT)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:MARIE
Last Name:THOR
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:RACHEL
Other - Middle Name:MARIE
Other - Last Name:MEEK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:124 SUMIDA GARDENS LN
Mailing Address - Street 2:319
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93111-2385
Mailing Address - Country:US
Mailing Address - Phone:805-464-6168
Mailing Address - Fax:
Practice Address - Street 1:5152 HOLLISTER AVE
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93111-2550
Practice Address - Country:US
Practice Address - Phone:805-681-9108
Practice Address - Fax:805-681-9208
Is Sole Proprietor?:No
Enumeration Date:2014-02-06
Last Update Date:2017-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT41815225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPT41815OtherPT LICENSE