=====================================================
General NPI Number Information
=====================================================
NPI Number | 1538875117
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | RACHEL BOWDLE
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/26/2023
-----------------------------------------------------
Last Update Date | 01/26/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 333 VILLAGE BLVD STE 201
-----------------------------------------------------
City | INCLINE VILLAGE
-----------------------------------------------------
State | NV
-----------------------------------------------------
Zip | 89451-8293
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 775-831-1964
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 668
-----------------------------------------------------
City | HOMEWOOD
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 96141-0668
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225100000X
-----------------------------------------------------
Taxonomy Name | Physical Therapist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------