Provider Demographics
NPI:1265751051
Name:SWEET, RACHEL (PT)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:
Last Name:SWEET
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4685 FOREST AVE C
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45212-3359
Mailing Address - Country:US
Mailing Address - Phone:513-853-4722
Mailing Address - Fax:513-852-8525
Practice Address - Street 1:10058 COOLEY RD
Practice Address - Street 2:#6
Practice Address - City:BROOKVILLE
Practice Address - State:IN
Practice Address - Zip Code:47012-9509
Practice Address - Country:US
Practice Address - Phone:765-647-0808
Practice Address - Fax:765-647-2728
Is Sole Proprietor?:No
Enumeration Date:2010-05-19
Last Update Date:2015-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN05010400A225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
INPENDINGMedicaid
IN000000669781OtherANTHEM PROVIDER NUMBER
INP00856466Medicare PIN
INM400021331Medicare PIN