Healthcare Provider Details

I. General information

NPI: 1174290191
Provider Name (Legal Business Name): RACHEL ELIZABETH SHEPHERD DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/26/2021
Last Update Date: 10/12/2022
Certification Date: 10/12/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

164 WETHERBY LN
WESTERVILLE OH
43081-4957
US

IV. Provider business mailing address

2717 BELLWOOD AVE
BEXLEY OH
43209-1017
US

V. Phone/Fax

Practice location:
  • Phone: 614-841-3900
  • Fax:
Mailing address:
  • Phone: 703-965-1735
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number016968
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: