Provider Demographics
NPI:1902295868
Name:BRADLEY, RACHEL FORBES (PT, DPT, OCS)
Entity Type:Individual
Prefix:DR
First Name:RACHEL
Middle Name:FORBES
Last Name:BRADLEY
Suffix:
Gender:F
Credentials:PT, DPT, OCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5848 S FASHION BLVD
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84107-6157
Mailing Address - Country:US
Mailing Address - Phone:801-314-4040
Mailing Address - Fax:801-314-4043
Practice Address - Street 1:5848 S FASHION BLVD
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84107-6157
Practice Address - Country:US
Practice Address - Phone:801-314-4040
Practice Address - Fax:801-314-4043
Is Sole Proprietor?:No
Enumeration Date:2015-01-15
Last Update Date:2017-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT296392251X0800X
UT9407490-24012251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic