Healthcare Provider Details
I. General information
NPI: 1366811184
Provider Name (Legal Business Name): RACHEL ANDERSON ZUMSTEIN PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 09/22/2015
Last Update Date: 11/09/2017
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2400 W MALLARD CREEK CHURCH RD SUITE A
CHARLOTTE NC
28262-2324
US
IV. Provider business mailing address
4601 PARK RD STE 300
CHARLOTTE NC
28209-3239
US
V. Phone/Fax
- Phone: 704-323-2000
- Fax:
- Phone: 704-323-2248
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 225100000X |
| Taxonomy | Physical Therapist |
| License Number | P15786 |
| License Number State | NC |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: