MEDICARE: DR. RACHAEL LYNN BREWER 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	PT015445	GA

General Provider Information

NPI Number	:	1477221158
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RACHAEL LYNN BREWER PT, DPT

Provider Business Mailing Address
First Line	:	241 JEFFERSON AVE
Second Line	:
City	:	CANTON
State	:	GA
Zip	:	30114-7549
Country	:	US
Telephone Number	:	770-322-4028
Fax Number	:	470-523-2650

Provider Business Practice Location Address
First Line	:	2499 PALM ST STE 200
Second Line	:
City	:	CANTON
State	:	GA
Zip	:	30115-8630
Country	:	US
Telephone Number	:	770-322-4028
Fax Number	:	470-523-2650

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

Provider Enumeration Date	:	08/30/2021
Last Update Date	:	05/08/2026

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