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NPI Code Detail

MEDICARE: DR. TRACIE ELLEN GEILE PT, DPT

MEDICARE: DR. TRACIE ELLEN GEILE 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 Therapist11-05697KS
2225100000XPhysical Therapist2017023461MO

General Provider Information

NPI Number : 1639690258
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. TRACIE ELLEN GEILE PT, DPT
Provider Business Mailing Address
First Line : 1107 CYPRESS POINT DR
Second Line :
City : O FALLON
State : MO
Zip : 63366-5582
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1475 KISKER RD STE 150
Second Line :
City : SAINT CHARLES
State : MO
Zip : 63304-8789
Country : US
Telephone Number : 636-498-7474
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/05/2017
Last Update Date : 07/06/2017

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