Provider Demographics
NPI:1679081210
Name:RANTANEN, RACHEL KRISTINE I (DPT)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:KRISTINE
Last Name:RANTANEN
Suffix:I
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1832 GOLDEN WILLOW CT
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80528-6391
Mailing Address - Country:US
Mailing Address - Phone:626-429-0411
Mailing Address - Fax:
Practice Address - Street 1:1832 GOLDEN WILLOW CT
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80528-6391
Practice Address - Country:US
Practice Address - Phone:626-429-0411
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-17
Last Update Date:2018-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist