Provider Demographics
NPI:1568654176
Name:SIZEMORE, RACHAEL (PT)
Entity type:Individual
Prefix:
First Name:RACHAEL
Middle Name:
Last Name:SIZEMORE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:650 N SHORELINE DR
Mailing Address - Street 2:
Mailing Address - City:WASILLA
Mailing Address - State:AK
Mailing Address - Zip Code:99654-6615
Mailing Address - Country:US
Mailing Address - Phone:907-376-6363
Mailing Address - Fax:907-376-6366
Practice Address - Street 1:11432 BUSINESS BLVD
Practice Address - Street 2:
Practice Address - City:EAGLE RIVER
Practice Address - State:AK
Practice Address - Zip Code:99577-7740
Practice Address - Country:US
Practice Address - Phone:907-376-6363
Practice Address - Fax:907-376-6366
Is Sole Proprietor?:No
Enumeration Date:2007-08-16
Last Update Date:2021-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK145820225100000X, 225100000X
AK1946225100000X
MA17752225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist