Provider Demographics
NPI:1467180612
Name:SCOTT, RACHEL (PT, DPT)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:
Last Name:SCOTT
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:RACHEL
Other - Middle Name:
Other - Last Name:NORMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7561 CLARK RD
Mailing Address - Street 2:
Mailing Address - City:BATH
Mailing Address - State:MI
Mailing Address - Zip Code:48808-9306
Mailing Address - Country:US
Mailing Address - Phone:760-567-9194
Mailing Address - Fax:
Practice Address - Street 1:2040 AURELIUS RD STE 5
Practice Address - Street 2:
Practice Address - City:HOLT
Practice Address - State:MI
Practice Address - Zip Code:48842-1367
Practice Address - Country:US
Practice Address - Phone:517-268-9040
Practice Address - Fax:517-268-9042
Is Sole Proprietor?:No
Enumeration Date:2022-08-15
Last Update Date:2024-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501302252225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI5501302252OtherPT LICENSE