MEDICARE: RACHAEL DIANE FRANCO P.T.

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
1	225200000X	Physical Therapy Assistant	AT8418	CA

General Provider Information

NPI Number	:	1699931683
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RACHAEL DIANE FRANCO P.T.

Provider Business Mailing Address
First Line	:	30670 PUDDING CREEK RD
Second Line	:
City	:	FORT BRAGG
State	:	CA
Zip	:	95437-8109
Country	:	US
Telephone Number	:	707-961-6191
Fax Number	:

Provider Business Practice Location Address
First Line	:	18661 OLD COAST HWY
Second Line	:
City	:	FORT BRAGG
State	:	CA
Zip	:	95437-8260
Country	:	US
Telephone Number	:	707-961-6191
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/30/2008
Last Update Date	:	07/30/2008

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