Provider Demographics
NPI:1447704689
Name:BADWAY, RACHEL (PT, DPT)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:
Last Name:BADWAY
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3865 INDIAN RUN DR
Mailing Address - Street 2:APT #2
Mailing Address - City:CANFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44406-9086
Mailing Address - Country:US
Mailing Address - Phone:330-717-3555
Mailing Address - Fax:
Practice Address - Street 1:38720 SALTWELL RD
Practice Address - Street 2:
Practice Address - City:LISBON
Practice Address - State:OH
Practice Address - Zip Code:44432-8303
Practice Address - Country:US
Practice Address - Phone:330-424-9591
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-04
Last Update Date:2016-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT016511225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist