Provider Demographics
NPI:1972663987
Name:TATE, RACHEL CARA (DPT)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:CARA
Last Name:TATE
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:RACHEL
Other - Middle Name:CARA
Other - Last Name:LABOV
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:PO BOX 60318
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-0318
Mailing Address - Country:US
Mailing Address - Phone:703-383-6424
Mailing Address - Fax:
Practice Address - Street 1:3620 JOSEPH SIEWICK DR STE 100A
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22033-1757
Practice Address - Country:US
Practice Address - Phone:703-810-5227
Practice Address - Fax:571-407-5661
Is Sole Proprietor?:No
Enumeration Date:2006-12-11
Last Update Date:2023-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA23052048692251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
538695Medicare PIN
021032C95Medicare PIN