Provider Demographics
NPI:1013434943
Name:GRIMMETT, RACHEL ANN (PT, DPT)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:ANN
Last Name:GRIMMETT
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:RACHEL
Other - Middle Name:ANN
Other - Last Name:SEALS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2918 PLEASANT GROVE RD
Mailing Address - Street 2:
Mailing Address - City:TEXARKANA
Mailing Address - State:TX
Mailing Address - Zip Code:75503-0064
Mailing Address - Country:US
Mailing Address - Phone:903-628-1214
Mailing Address - Fax:903-347-2255
Practice Address - Street 1:2918 PLEASANT GROVE RD
Practice Address - Street 2:
Practice Address - City:TEXARKANA
Practice Address - State:TX
Practice Address - Zip Code:75503-0064
Practice Address - Country:US
Practice Address - Phone:903-628-1214
Practice Address - Fax:903-347-2255
Is Sole Proprietor?:No
Enumeration Date:2017-08-22
Last Update Date:2023-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1296939225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist