Provider Demographics
NPI:1821859067
Name:REDMOND, RACHEL E (DOM, LAC)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:E
Last Name:REDMOND
Suffix:
Gender:F
Credentials:DOM, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:225 OXFORD RD
Mailing Address - Street 2:
Mailing Address - City:EAST LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48823-2626
Mailing Address - Country:US
Mailing Address - Phone:917-675-2813
Mailing Address - Fax:
Practice Address - Street 1:2820 COVINGTON CT
Practice Address - Street 2:
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48912-4810
Practice Address - Country:US
Practice Address - Phone:917-675-2813
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-16
Last Update Date:2024-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5402000207171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist