Provider Demographics
NPI:1124450804
Name:PHIPPS, RACHEL
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:
Last Name:PHIPPS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:RACHEL
Other - Middle Name:
Other - Last Name:WEINHOLD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1389 WEBER INDUSTRIAL DR
Mailing Address - Street 2:
Mailing Address - City:CUMMING
Mailing Address - State:GA
Mailing Address - Zip Code:30041-6468
Mailing Address - Country:US
Mailing Address - Phone:770-886-6204
Mailing Address - Fax:
Practice Address - Street 1:1389 WEBER INDUSTRIAL DR
Practice Address - Street 2:
Practice Address - City:CUMMING
Practice Address - State:GA
Practice Address - Zip Code:30041-6468
Practice Address - Country:US
Practice Address - Phone:770-886-6204
Practice Address - Fax:678-261-6421
Is Sole Proprietor?:No
Enumeration Date:2013-08-05
Last Update Date:2014-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT011141225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist