Provider Demographics
NPI:1699444687
Name:RABACH, COLIN THOMAS (PA-C)
Entity type:Individual
Prefix:
First Name:COLIN
Middle Name:THOMAS
Last Name:RABACH
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9883 US 31
Mailing Address - Street 2:
Mailing Address - City:MONTAGUE
Mailing Address - State:MI
Mailing Address - Zip Code:49437-9501
Mailing Address - Country:US
Mailing Address - Phone:231-893-6363
Mailing Address - Fax:231-893-1236
Practice Address - Street 1:9883 US 31
Practice Address - Street 2:
Practice Address - City:MONTAGUE
Practice Address - State:MI
Practice Address - Zip Code:49437-9501
Practice Address - Country:US
Practice Address - Phone:231-893-6363
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-13
Last Update Date:2025-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant