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NPI Code Detail

MEDICARE: RACHEL GLENDINE OTTAWAY DPT

MEDICARE: RACHEL GLENDINE OTTAWAY DPT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist006694KY

General Provider Information

NPI Number : 1689050825
Entity Type Code : Individual
Provider Name (Legal Business Name) : RACHEL GLENDINE OTTAWAY DPT
Provider Business Mailing Address
First Line : 1755 WITTINGTON PL STE 175
Second Line :
City : DALLAS
State : TX
Zip : 75234-1905
Country : US
Telephone Number : 866-221-5405
Fax Number : 866-534-5697
Provider Business Practice Location Address
First Line : 1755 WITTINGTON PL STE 175
Second Line :
City : DALLAS
State : TX
Zip : 75234-1905
Country : US
Telephone Number : 866-221-5405
Fax Number : 866-534-5697
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/10/2015
Last Update Date : 08/10/2015

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Directions to “ RACHEL GLENDINE OTTAWAY DPT” Practice Location

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