MEDICARE: MR. HARRY EUGENE RAYHEL P.T.

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	R0992	IN

General Provider Information

NPI Number	:	1245266923
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. HARRY EUGENE RAYHEL P.T.

Provider Business Mailing Address
First Line	:	2845 VETERANS MEMORIAL PKWY
Second Line	:
City	:	SAINT CHARLES
State	:	MO
Zip	:	63303-3526
Country	:	US
Telephone Number	:	314-286-6988
Fax Number	:

Provider Business Practice Location Address
First Line	:	2845 VETERANS MEMORIAL PKWY
Second Line	:
City	:	SAINT CHARLES
State	:	MO
Zip	:	63303-3526
Country	:	US
Telephone Number	:	313-286-6988
Fax Number	:

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

Provider Enumeration Date	:	06/24/2006
Last Update Date	:	06/11/2024

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