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General NPI Number Information
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NPI Number | 1265848634
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Entity Type | Individual
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Provider Name | RACHEL LOPP MS, LAT, ATC
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Gender | Female
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Dates
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Enumeration Date | 07/07/2014
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Last Update Date | 02/14/2019
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Provider Practice Location Address
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Address Line | BLD 901 ROOM 131
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City | FORT LEONARD WOOD
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State | MO
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Zip | 65473
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Country | US
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Telephone | 573-596-4502
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 55
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City | FORT LEONARD WOOD
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State | MO
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Zip | 65473-0055
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | AT.004183
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | 2015012980
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License Number State | MO
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