Provider Demographics
NPI:1922667179
Name:SUTTON, RACHEL R (DPT)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:R
Last Name:SUTTON
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 1:11 N SCOTTSDALE ST
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67230-6629
Mailing Address - Country:US
Mailing Address - Phone:620-440-1811
Mailing Address - Fax:
Practice Address - Street 1:11 N SCOTTSDALE ST
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67230-6629
Practice Address - Country:US
Practice Address - Phone:620-440-1811
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-11
Last Update Date:2023-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPTL.0017155225100000X
KS11-06146225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist