Provider Demographics
NPI:1669208336
Name:GAMMON, RACHEL LYNNE (DC)
Entity type:Individual
Prefix:DR
First Name:RACHEL
Middle Name:LYNNE
Last Name:GAMMON
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:215 S ROCK ST UNIT 9
Mailing Address - Street 2:
Mailing Address - City:GEORGETOWN
Mailing Address - State:TX
Mailing Address - Zip Code:78626-2539
Mailing Address - Country:US
Mailing Address - Phone:830-237-1934
Mailing Address - Fax:
Practice Address - Street 1:5820 WILLIAMS DR STE ABC
Practice Address - Street 2:
Practice Address - City:GEORGETOWN
Practice Address - State:TX
Practice Address - Zip Code:78633-8614
Practice Address - Country:US
Practice Address - Phone:512-686-7458
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-10
Last Update Date:2024-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX16164111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor