Provider Demographics
NPI:1487980595
Name:SMITH, RACHEL L (PT)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:L
Last Name:SMITH
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:RACHEL
Other - Middle Name:L
Other - Last Name:GENNARO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:311 S PARKWAY
Mailing Address - Street 2:APT 301F
Mailing Address - City:BROOMALL
Mailing Address - State:PA
Mailing Address - Zip Code:19008-3651
Mailing Address - Country:US
Mailing Address - Phone:856-982-1968
Mailing Address - Fax:
Practice Address - Street 1:580 REED RD
Practice Address - Street 2:SUTE 3
Practice Address - City:BROOMALL
Practice Address - State:PA
Practice Address - Zip Code:19008-3655
Practice Address - Country:US
Practice Address - Phone:610-356-6211
Practice Address - Fax:610-356-1429
Is Sole Proprietor?:No
Enumeration Date:2009-10-23
Last Update Date:2024-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT-020255225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist