Basic Information
Provider Information
NPI: 1952943680
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: KNIGHT
FirstName: RACHEL
MiddleName:  
NamePrefix:  
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Credential:  
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Mailing Information
Address1: 5710 OLEANDER DR
Address2: STE 211
City: WILMINGTON
State: NC
PostalCode: 284034722
CountryCode: US
TelephoneNumber: 4236828840
FaxNumber: 4236022028
Practice Location
Address1: 503 OLDE WATERFORD WAY STE 205
Address2:  
City: LELAND
State: NC
PostalCode: 284514148
CountryCode: US
TelephoneNumber: 9103994039
FaxNumber: 9107692552
Other Information
ProviderEnumerationDate: 10/15/2019
LastUpdateDate: 12/30/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
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IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
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AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 12/30/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225100000XP19036NCY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 

No ID Information.


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