Provider Demographics
NPI:1457539413
Name:WITMER, RACHEL (DP T)
Entity Type:Individual
Prefix:DR
First Name:RACHEL
Middle Name:
Last Name:WITMER
Suffix:
Gender:F
Credentials:DP T
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 COLLINS RD NE # 154-100
Mailing Address - Street 2:
Mailing Address - City:CEDAR RAPIDS
Mailing Address - State:IA
Mailing Address - Zip Code:52498-0505
Mailing Address - Country:US
Mailing Address - Phone:319-295-8899
Mailing Address - Fax:319-295-8833
Practice Address - Street 1:400 COLLINS RD NE # 154-100
Practice Address - Street 2:
Practice Address - City:CEDAR RAPIDS
Practice Address - State:IA
Practice Address - Zip Code:52498-0505
Practice Address - Country:US
Practice Address - Phone:319-295-8899
Practice Address - Fax:319-295-8833
Is Sole Proprietor?:No
Enumeration Date:2008-02-01
Last Update Date:2015-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA004192225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IAI19172Medicare PIN
IAIB1212028Medicare PIN
IAI19172054Medicare PIN
IAIB1213028Medicare PIN
IAIB1213Medicare PIN
IAIB1212Medicare PIN