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NPI Code Detail

MEDICARE: RACHEL KORCHNAK

MEDICARE: RACHEL KORCHNAK
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1224Z00000XOccupational Therapy Assistant

General Provider Information

NPI Number : 1235696865
Entity Type Code : Individual
Provider Name (Legal Business Name) : RACHEL KORCHNAK
Provider Business Mailing Address
First Line : 1949 LAKEWOOD CIR S
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32207-7841
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 7723 JASPER AVE
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32211-7719
Country : US
Telephone Number : 904-725-8044
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/01/2019
Last Update Date : 03/01/2019

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