Provider Demographics
NPI:1972830800
Name:WALDEN, RACHAEL LYNN (DC)
Entity Type:Individual
Prefix:DR
First Name:RACHAEL
Middle Name:LYNN
Last Name:WALDEN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:RACHAEL
Other - Middle Name:LYNN
Other - Last Name:MONTS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:1285 PARKWAY DR
Mailing Address - Street 2:
Mailing Address - City:ZIONSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46077-1953
Mailing Address - Country:US
Mailing Address - Phone:317-491-1073
Mailing Address - Fax:
Practice Address - Street 1:1285 PARKWAY DR
Practice Address - Street 2:
Practice Address - City:ZIONSVILLE
Practice Address - State:IN
Practice Address - Zip Code:46077-1953
Practice Address - Country:US
Practice Address - Phone:317-491-1073
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-13
Last Update Date:2014-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN08002482A111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor