Healthcare Provider Details

I. General information

NPI: 1235305467
Provider Name (Legal Business Name): RACHEL CHERIE CAREY PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/07/2008
Last Update Date: 05/07/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1460 EAST VALLEY ROAD SUITE 101
BASALT CO
81621
US

IV. Provider business mailing address

1517 BLAKE AVE SUITE 203
GLENWOOD SPRINGS CO
81601-3643
US

V. Phone/Fax

Practice location:
  • Phone: 970-927-1701
  • Fax: 970-947-9916
Mailing address:
  • Phone: 970-947-1701
  • Fax: 970-947-9916

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number9830
License Number StateCO

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: