Healthcare Provider Details

I. General information

NPI: 1467242446
Provider Name (Legal Business Name): RACHEL CLAYTON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/12/2025
Last Update Date: 05/12/2025
Certification Date: 05/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7200 E JIM COTTRELL CIR
PALMER AK
99654
US

IV. Provider business mailing address

1026 W CLIVEDEN ST
PHILADELPHIA PA
19119-3701
US

V. Phone/Fax

Practice location:
  • Phone: 907-214-1968
  • Fax:
Mailing address:
  • Phone: 616-322-7505
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code2251P0200X
TaxonomyPediatric Physical Therapist
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: