Provider Demographics
NPI:1730578030
Name:MCCARTHY, RAYCHEL (ATC)
Entity type:Individual
Prefix:
First Name:RAYCHEL
Middle Name:
Last Name:MCCARTHY
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1609 FOREST GLENN CIR
Mailing Address - Street 2:
Mailing Address - City:CHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:23836-6113
Mailing Address - Country:US
Mailing Address - Phone:804-943-3363
Mailing Address - Fax:
Practice Address - Street 1:1609 FOREST GLENN CIR
Practice Address - Street 2:
Practice Address - City:CHESTER
Practice Address - State:VA
Practice Address - Zip Code:23836-6113
Practice Address - Country:US
Practice Address - Phone:804-943-3363
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-01-10
Last Update Date:2015-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01260020652255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer