=====================================================
General NPI Number Information
=====================================================
NPI Number | 1922823335
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | RACHAEL NEATROUR DPT
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/20/2024
-----------------------------------------------------
Last Update Date | 11/20/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2140 WARRENSVILLE RD
-----------------------------------------------------
City | MONTOURSVILLE
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 17754-9621
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 570-435-8700
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 282 BROADWAY ST
-----------------------------------------------------
City | HUGHESVILLE
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 17737-1612
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 570-971-9130
-----------------------------------------------------
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 | PT032888
-----------------------------------------------------
License Number State | PA
-----------------------------------------------------