Provider Demographics
NPI:1295119964
Name:SPOTZ, RACHEL LYNNE (MS, ATC, LAT)
Entity type:Individual
Prefix:MRS
First Name:RACHEL
Middle Name:LYNNE
Last Name:SPOTZ
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 1:15422 ALDRICH LN
Mailing Address - Street 2:
Mailing Address - City:PERRY
Mailing Address - State:KS
Mailing Address - Zip Code:66073-4021
Mailing Address - Country:US
Mailing Address - Phone:785-865-6339
Mailing Address - Fax:
Practice Address - Street 1:15422 ALDRICH LN
Practice Address - Street 2:
Practice Address - City:PERRY
Practice Address - State:KS
Practice Address - Zip Code:66073-4021
Practice Address - Country:US
Practice Address - Phone:785-865-6339
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-13
Last Update Date:2015-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20140365552255A2300X
KS24-009942255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer