Provider Demographics
NPI:1902594484
Name:MATULLE, RACHEL M (DPT)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:M
Last Name:MATULLE
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1511 S COMMERCIAL ST
Mailing Address - Street 2:
Mailing Address - City:NEENAH
Mailing Address - State:WI
Mailing Address - Zip Code:54956-4801
Mailing Address - Country:US
Mailing Address - Phone:920-720-0660
Mailing Address - Fax:920-720-0666
Practice Address - Street 1:1511 S COMMERCIAL ST
Practice Address - Street 2:
Practice Address - City:NEENAH
Practice Address - State:WI
Practice Address - Zip Code:54956-4801
Practice Address - Country:US
Practice Address - Phone:920-720-0660
Practice Address - Fax:920-720-0666
Is Sole Proprietor?:No
Enumeration Date:2023-04-24
Last Update Date:2025-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI16577-24225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist