Healthcare Provider Details

I. General information

NPI: 1245266923
Provider Name (Legal Business Name): HARRY EUGENE RAYHEL P.T.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/24/2006
Last Update Date: 06/11/2024
Certification Date: 06/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2845 VETERANS MEMORIAL PKWY
SAINT CHARLES MO
63303-3526
US

IV. Provider business mailing address

2845 VETERANS MEMORIAL PKWY
SAINT CHARLES MO
63303-3526
US

V. Phone/Fax

Practice location:
  • Phone: 313-286-6988
  • Fax:
Mailing address:
  • Phone: 314-286-6988
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberR0992
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: