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General NPI Number Information
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NPI Number | 1922467802
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Entity Type | Individual
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Provider Name | RACHEL HANNUM-GRINSTEAD D.P.T., A.T.C
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Gender | Female
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Dates
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Enumeration Date | 02/19/2016
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Last Update Date | 02/19/2016
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Provider Practice Location Address
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Address Line | CMR 402
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City | APO
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State | AE
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Zip | 09180
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Country | US
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Telephone | 314-590-7298
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Fax |
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Provider Business Mailing Address
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Address Line | PSC 2 BOX 15675
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City | APO
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State | AE
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Zip | 09012-0157
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Country | US
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Telephone | 015166057884
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 4558
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License Number State | NM
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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 | 2000005401
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License Number State | WV
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