Provider Demographics
NPI:1558826081
Name:CHERRY, RACHEL ANN
Entity type:Individual
Prefix:DR
First Name:RACHEL
Middle Name:ANN
Last Name:CHERRY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:222 GRAYROCK DR
Mailing Address - Street 2:
Mailing Address - City:STATESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28677-2480
Mailing Address - Country:US
Mailing Address - Phone:615-489-3613
Mailing Address - Fax:
Practice Address - Street 1:236 LEPHILLIP COURT
Practice Address - Street 2:SUITE A
Practice Address - City:CONCORD
Practice Address - State:NC
Practice Address - Zip Code:28025
Practice Address - Country:US
Practice Address - Phone:704-707-4282
Practice Address - Fax:704-795-4389
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-08
Last Update Date:2019-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP18536225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist