MEDICARE: RACHEL BROOKE PETERSON 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
1	225100000X	Physical Therapist	11-07191	KS

General Provider Information

NPI Number	:	1174256036
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RACHEL BROOKE PETERSON PT, DPT

Provider Business Mailing Address
First Line	:	1200 CORPORATE DR STE 400
Second Line	:
City	:	HOOVER
State	:	AL
Zip	:	35242-5424
Country	:	US
Telephone Number	:	423-238-7217
Fax Number	:

Provider Business Practice Location Address
First Line	:	3627 SE 29TH ST STE 107
Second Line	:
City	:	TOPEKA
State	:	KS
Zip	:	66605-2013
Country	:	US
Telephone Number	:	785-266-4600
Fax Number	:	785-266-4601

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

Provider Enumeration Date	:	07/07/2022
Last Update Date	:	12/02/2022

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