Provider Demographics
NPI:1700556198
Name:BUDDEMEYER, RACHEL PAIGE FIELDS (DPT)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:PAIGE FIELDS
Last Name:BUDDEMEYER
Suffix:
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 1:100 DEPOT ST
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:KY
Mailing Address - Zip Code:40069
Mailing Address - Country:US
Mailing Address - Phone:859-336-9901
Mailing Address - Fax:
Practice Address - Street 1:100 DEPOT STREET
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:KY
Practice Address - Zip Code:40069
Practice Address - Country:US
Practice Address - Phone:859-336-9901
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-16
Last Update Date:2024-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225100000X
KY008415225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist