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NPI Code Detail

MEDICARE: JOHN N RAICHE

MEDICARE: JOHN N RAICHE
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
1175T00000XPeer Specialist

General Provider Information

NPI Number : 1225509045
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOHN N RAICHE
Provider Business Mailing Address
First Line : 523 S EATON ST
Second Line :
City : LAKEWOOD
State : CO
Zip : 80226-3548
Country : US
Telephone Number : 720-987-0025
Fax Number :
Provider Business Practice Location Address
First Line : 1648 GAYLORD ST
Second Line :
City : DENVER
State : CO
Zip : 80206-1239
Country : US
Telephone Number : 303-333-4288
Fax Number : 303-336-1632
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/06/2018
Last Update Date : 12/06/2018

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Directions to “ JOHN N RAICHE ” Practice Location

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