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NPI Code Detail

MEDICARE: RACHEL LYNN KIMMICH PT, DPT

MEDICARE: RACHEL LYNN KIMMICH PT, DPT
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
1225100000XPhysical Therapist11-06456KS
2225100000XPhysical Therapist2020025286MO

General Provider Information

NPI Number : 1073121208
Entity Type Code : Individual
Provider Name (Legal Business Name) : RACHEL LYNN KIMMICH PT, DPT
Provider Business Mailing Address
First Line : 6397 LEE HWY STE 300
Second Line :
City : CHATTANOOGA
State : TN
Zip : 37421-4915
Country : US
Telephone Number : 423-238-7217
Fax Number :
Provider Business Practice Location Address
First Line : 220 NW PLATTE VALLEY DR
Second Line :
City : RIVERSIDE
State : MO
Zip : 64150-9793
Country : US
Telephone Number : 816-741-6374
Fax Number : 816-505-3312
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/14/2020
Last Update Date : 08/07/2020

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