Provider Demographics
NPI:1952813677
Name:ZIEGLER, RAQUEL (PT, DPT)
Entity Type:Individual
Prefix:MRS
First Name:RAQUEL
Middle Name:
Last Name:ZIEGLER
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 135
Mailing Address - Street 2:
Mailing Address - City:NETTLETON
Mailing Address - State:MS
Mailing Address - Zip Code:38858-0135
Mailing Address - Country:US
Mailing Address - Phone:662-591-7077
Mailing Address - Fax:662-591-7078
Practice Address - Street 1:230-A MAIN ST.
Practice Address - Street 2:
Practice Address - City:NETTLETON
Practice Address - State:MS
Practice Address - Zip Code:38858
Practice Address - Country:US
Practice Address - Phone:662-591-7077
Practice Address - Fax:662-591-7078
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-03
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSPT6305225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist