Doctor Name: | RACHEL LAUREN RIDENOUR |
NPI Number: | 1104296730 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PT |
License Number: | 1232721 |
Business Practice Address: | 6500 Excelsior Blvd St Louis Park, MN - 554264702 |
Business Phone Number: | 9529935486 |
Business Fax Number: | |
Mailing Address: | 20 6th St Nw, Apt 126 OSSEO |
State: | MN |
Postal Code: | 553691189 |
Phone Number: | 4058800696 |
Fax Number: | |
NPI Enumeration Date: | 09/24/2015 |
NPI Last Update Date: | 09/24/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | 1232721 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Physical Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |