Provider Demographics
NPI:1083127385
Name:RUEL, RACHEL COLLEEN (DPT)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:COLLEEN
Last Name:RUEL
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:RACHEL
Other - Middle Name:COLLEEN
Other - Last Name:JESPERSEN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:141 ATRIUM WAY
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29223-6301
Mailing Address - Country:US
Mailing Address - Phone:803-788-8484
Mailing Address - Fax:803-788-8499
Practice Address - Street 1:2460 INDIA HOOK RD STE 107
Practice Address - Street 2:
Practice Address - City:ROCK HILL
Practice Address - State:SC
Practice Address - Zip Code:29732-3531
Practice Address - Country:US
Practice Address - Phone:803-658-4073
Practice Address - Fax:803-329-1696
Is Sole Proprietor?:No
Enumeration Date:2017-11-08
Last Update Date:2025-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD26667225100000X
SC12267225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist