Healthcare Provider Details

I. General information

NPI: 1417534637
Provider Name (Legal Business Name): RACHEL L. RIEL PA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/25/2021
Last Update Date: 01/29/2026
Certification Date: 01/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 STATE ROUTE 664 N
LOGAN OH
43138-8541
US

IV. Provider business mailing address

700 ACKERMAN RD STE 2120
COLUMBUS OH
43202-1559
US

V. Phone/Fax

Practice location:
  • Phone: 740-380-8000
  • Fax:
Mailing address:
  • Phone: 740-380-8000
  • Fax: 614-293-2809

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number50.006872RX
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: