Provider Demographics
NPI:1184991937
Name:PLOOR, RACHEL (MS, ATC, LAT)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:
Last Name:PLOOR
Suffix:
Gender:F
Credentials:MS, ATC, LAT
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 8082
Mailing Address - Street 2:
Mailing Address - City:STATESBORO
Mailing Address - State:GA
Mailing Address - Zip Code:30460-1000
Mailing Address - Country:US
Mailing Address - Phone:912-478-7582
Mailing Address - Fax:
Practice Address - Street 1:590 HERTY DRIVE
Practice Address - Street 2:HANNER FIELD HOUSE ROOM 1216
Practice Address - City:STATEBORO
Practice Address - State:GA
Practice Address - Zip Code:30458
Practice Address - Country:US
Practice Address - Phone:912-536-3155
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-11-22
Last Update Date:2014-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARAT 5252255A2300X
GAAT0023502255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer