MEDICARE: JOEL RAUSER BMR, PT, MTC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	8153	CO

General Provider Information

NPI Number	:	1235229881
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOEL RAUSER BMR, PT, MTC

Provider Business Mailing Address
First Line	:	2140 ACADEMY CIR
Second Line	:	SUITE A
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80909-1690
Country	:	US
Telephone Number	:	719-596-5000
Fax Number	:	719-596-0890

Provider Business Practice Location Address
First Line	:	2140 ACADEMY CIR
Second Line	:	SUITE A
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80909-1690
Country	:	US
Telephone Number	:	719-596-5000
Fax Number	:	719-596-0890

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/13/2006
Last Update Date	:	07/08/2007

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