Provider Demographics
NPI:1316946205
Name:BLACKWOOD, RACHEL ROSS (DPT)
Entity type:Individual
Prefix:DR
First Name:RACHEL
Middle Name:ROSS
Last Name:BLACKWOOD
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1694
Mailing Address - Street 2:
Mailing Address - City:CALERA
Mailing Address - State:AL
Mailing Address - Zip Code:35040-1694
Mailing Address - Country:US
Mailing Address - Phone:205-621-3077
Mailing Address - Fax:205-621-3788
Practice Address - Street 1:101 HIGHWAY 87
Practice Address - Street 2:SUITE 100
Practice Address - City:CALERA
Practice Address - State:AL
Practice Address - Zip Code:35040
Practice Address - Country:US
Practice Address - Phone:205-621-3077
Practice Address - Fax:205-621-3788
Is Sole Proprietor?:No
Enumeration Date:2005-07-21
Last Update Date:2021-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALPTH4114174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL016591Medicare ID - Type Unspecified