Provider Demographics
NPI:1295760171
Name:RESCH, RACHAEL RUTH (PT)
Entity type:Individual
Prefix:MS
First Name:RACHAEL
Middle Name:RUTH
Last Name:RESCH
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:PO BOX 702
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97520-0024
Mailing Address - Country:US
Mailing Address - Phone:541-301-3493
Mailing Address - Fax:541-224-8884
Practice Address - Street 1:280 E HERSEY ST STE 17
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:OR
Practice Address - Zip Code:97520-3940
Practice Address - Country:US
Practice Address - Phone:541-301-3493
Practice Address - Fax:541-224-8884
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2018-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR2229225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORR108608Medicare PIN
ORR108608Medicare ID - Type Unspecified