Connie J Rackley
Individual provider Active NPI Physical Therapist · MC Rae, AR
NPI 1144534090 · NPPES record last updated Aug 3, 2010
Key facts
- NPI
- 1144534090
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 1395 (AR)
- Practice address
- 5140 Highway 367 S
MC Rae, AR 72102-9656 - Phone
- (501) 726-8080
- Fax
- (501) 726-8081
- NPI assigned
- Aug 3, 2010
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1395 | AR | MD | Physical Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 1395 | AR | Yes |
Addresses
Primary practice location
5140 Highway 367 S
MC Rae, AR 72102-9656
Mailing address
5140 Highway 367 S
MC Rae, AR 72102-9656
Phone (501) 726-8080
Other providers in MC Rae, AR
All providers in MC Rae, AR · Physical Therapist in Arkansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 3, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.