Basic Information
| Provider Information | |||||||||
| NPI: | 1174621049 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | WERSTAK | ||||||||
| FirstName: | RACHAEL | ||||||||
| MiddleName: | |||||||||
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| Credential: | PT | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | KARPINSKI | ||||||||
| OtherFirstName: | RACHAEL | ||||||||
| OtherMiddleName: | CAROL | ||||||||
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| OtherCredential: | PT | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 7782 BLUE ASH CT | ||||||||
| Address2: | |||||||||
| City: | CANAL WINCHESTER | ||||||||
| State: | OH | ||||||||
| PostalCode: | 431109699 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6144706240 | ||||||||
| FaxNumber: | 6144706244 | ||||||||
| Practice Location | |||||||||
| Address1: | 156 GRANVILLE ST | ||||||||
| Address2: | |||||||||
| City: | GAHANNA | ||||||||
| State: | OH | ||||||||
| PostalCode: | 432306505 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6144706240 | ||||||||
| FaxNumber: | 6144706244 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/21/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.