Provider Demographics
NPI:1124451034
Name:GMACH, RACHEL MARIE (PT)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:MARIE
Last Name:GMACH
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:RACHEL
Other - Middle Name:MARIE
Other - Last Name:KROHN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8613 TAMARRON DR
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28277-1854
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7580 CHARLOTTE HWY
Practice Address - Street 2:SUITE 1100
Practice Address - City:INDIAN LAND
Practice Address - State:SC
Practice Address - Zip Code:29707-7801
Practice Address - Country:US
Practice Address - Phone:803-548-5662
Practice Address - Fax:803-548-5635
Is Sole Proprietor?:No
Enumeration Date:2013-08-14
Last Update Date:2022-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCPT14781225100000X
SC7967225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC14781OtherNC LICENSE
NC14781OtherNC LICENSE