Provider Demographics
NPI:1235230970
Name:ELDREDGE, RACHEL ANN (ATC)
Entity type:Individual
Prefix:MISS
First Name:RACHEL
Middle Name:ANN
Last Name:ELDREDGE
Suffix:
Gender:
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1032
Mailing Address - Street 2:
Mailing Address - City:MIDDLEBURY
Mailing Address - State:VT
Mailing Address - Zip Code:05753-5032
Mailing Address - Country:US
Mailing Address - Phone:802-989-8198
Mailing Address - Fax:
Practice Address - Street 1:315 FALLS AVE
Practice Address - Street 2:
Practice Address - City:TWIN FALLS
Practice Address - State:ID
Practice Address - Zip Code:83301-3389
Practice Address - Country:US
Practice Address - Phone:802-989-8198
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-26
Last Update Date:2025-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDAT-8302255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer