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General NPI Number Information
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NPI Number | 1790278950
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Entity Type | Individual
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Provider Name | RACHEL RUTH MAXWELL DPT
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Gender | Female
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Dates
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Enumeration Date | 06/12/2018
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Last Update Date | 06/12/2018
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Provider Practice Location Address
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Address Line | 1338 PHAY AVE
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City | CANON CITY
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State | CO
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Zip | 81212-2311
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Country | US
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Telephone | 719-285-2600
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Fax |
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Provider Business Mailing Address
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Address Line | 855 MELANY LN
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City | COLORADO SPRINGS
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State | CO
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Zip | 80907-5972
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 12967
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License Number State | CO
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