Provider Demographics
NPI:1295313096
Name:BORNTRAGER, RACHEL (NBCHWC)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:
Last Name:BORNTRAGER
Suffix:
Gender:F
Credentials:NBCHWC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26 9 MILE RD
Mailing Address - Street 2:
Mailing Address - City:RAYMOND
Mailing Address - State:MT
Mailing Address - Zip Code:59256-7500
Mailing Address - Country:US
Mailing Address - Phone:406-765-7259
Mailing Address - Fax:
Practice Address - Street 1:626 W 1ST AVE
Practice Address - Street 2:
Practice Address - City:PLENTYWOOD
Practice Address - State:MT
Practice Address - Zip Code:59254-1504
Practice Address - Country:US
Practice Address - Phone:406-765-7259
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-01
Last Update Date:2021-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date: