Provider Demographics
NPI:1427512409
Name:WURDEMANN, RACHEL KATHRYN (DC)
Entity type:Individual
Prefix:DR
First Name:RACHEL
Middle Name:KATHRYN
Last Name:WURDEMANN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:RACHEL
Other - Middle Name:KATHRYN
Other - Last Name:SCHMIDT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:130 RIVER LANDING DR UNIT 11102
Mailing Address - Street 2:
Mailing Address - City:DANIEL ISLAND
Mailing Address - State:SC
Mailing Address - Zip Code:29492-7427
Mailing Address - Country:US
Mailing Address - Phone:651-724-7094
Mailing Address - Fax:
Practice Address - Street 1:194 SEVEN FARMS DR UNIT 600D
Practice Address - Street 2:
Practice Address - City:DANIEL ISLAND
Practice Address - State:SC
Practice Address - Zip Code:29492-8509
Practice Address - Country:US
Practice Address - Phone:843-751-2234
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-24
Last Update Date:2019-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC4372111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor