Basic Information
Provider Information
NPI: 1649735945
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: RAMSEY
FirstName: RACHAEL
MiddleName: LYNN
NamePrefix:  
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Credential:  
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Mailing Information
Address1: 607 FRONT ST
Address2:  
City: MARYVILLE
State: TN
PostalCode: 378044222
CountryCode: US
TelephoneNumber: 8654557653
FaxNumber:  
Practice Location
Address1: 2320 E LAMAR ALEXANDER PKWY
Address2:  
City: MARYVILLE
State: TN
PostalCode: 378045316
CountryCode: US
TelephoneNumber: 8652738300
FaxNumber:  
Other Information
ProviderEnumerationDate: 01/31/2019
LastUpdateDate: 01/31/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
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IsSoleProprietor: N
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AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225200000X6588TNY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant 

No ID Information.


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