MEDICARE: MS. RACHAEL JANE GEARY

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	224Y00000X	Clinical Exercise Physiologist	478259	CO
2	224Z00000X	Occupational Therapy Assistant	478259	CO

General Provider Information

NPI Number	:	1235851627
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. RACHAEL JANE GEARY

Provider Business Mailing Address
First Line	:	1110 N DOWNING ST APT 2
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80218-2925
Country	:	US
Telephone Number	:	321-525-6453
Fax Number	:

Provider Business Practice Location Address
First Line	:	1110 N DOWNING ST APT 2
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80218-2925
Country	:	US
Telephone Number	:	321-525-6453
Fax Number	:

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

Provider Enumeration Date	:	09/13/2022
Last Update Date	:	09/16/2022

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Directions to “ MS. RACHAEL JANE GEARY ” Practice Location

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