Healthcare Provider Details

I. General information

NPI: 1275528424
Provider Name (Legal Business Name): VALERIE L RAYCE PTA, ATC, LAT
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 09/14/2005
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1780 E US HIGHWAY 40
GREENCASTLE IN
46135-8722
US

IV. Provider business mailing address

5713 E COUNTY ROAD 700 S
GREENCASTLE IN
46135-8096
US

V. Phone/Fax

Practice location:
  • Phone: 765-653-3610
  • Fax: 765-653-3610
Mailing address:
  • Phone: 765-526-6328
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number06001751A
License Number StateIN
# 2
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number36000339A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: