Provider Demographics
NPI:1366909897
Name:MATTHEWS, RACHEL MONIQUE (ATC)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:MONIQUE
Last Name:MATTHEWS
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2399 PARKLAND DR NE UNIT 1214
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30324-7016
Mailing Address - Country:US
Mailing Address - Phone:240-354-4424
Mailing Address - Fax:
Practice Address - Street 1:150 BOBBY DODD WAY NW
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30332-2500
Practice Address - Country:US
Practice Address - Phone:240-354-4424
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-20
Last Update Date:2019-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0022762255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer