MEDICARE: RACHEL DISTELRATH

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	102031	MO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	102031	OTHER	MO	LICENSE #

General Provider Information

NPI Number	:	1699885988
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RACHEL DISTELRATH

Provider Business Mailing Address
First Line	:	405 SPRING VALLEY CT
Second Line	:
City	:	CHESTERFIELD
State	:	MO
Zip	:	63017-2721
Country	:	US
Telephone Number	:	314-514-8610
Fax Number	:

Provider Business Practice Location Address
First Line	:	12539 OLIVE BLVD
Second Line	:
City	:	CREVE COEUR
State	:	MO
Zip	:	63141-6311
Country	:	US
Telephone Number	:	314-205-2006
Fax Number	:

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

Provider Enumeration Date	:	08/30/2006
Last Update Date	:	04/26/2017

Similar Medicare Providers

1093745507 — MRS. KATHLEEN M MONZYK PT
Practice Location Address:

12539 OLIVE BLVD
CREVE COEUR, MO
63141-6311

Practice Phone: 314-205-2006
Practice Fax: 142-052-2413

1497819494 — ADVANCED FAMILY MEDICAL CARE, LLC
Practice Location Address:

12597 OLIVE BLVD
CREVE COEUR, MO
63141-6311

Practice Phone: 618-779-5508
Practice Fax: 618-206-8588

1245467265 — WILLIAM JOSEPH GROUP, LLC
Practice Location Address:

12597 OLIVE BLVD
CREVE COEUR, MO
63141-6311

Practice Phone: 314-205-0900
Practice Fax: 314-205-0905

1851847396 — VISIONWORKS INC.
Practice Location Address:

12597 OLIVE BLVD.
CREVE COEUR, MO
63141-6311

Practice Phone: 314-628-9366
Practice Fax: 314-628-9603

1679021802 — ELIZABETH PYTLINSKI PHARM.D.
Practice Location Address:

12595 OLIVE BLVD
CREVE COEUR, MO
63141-6311

Practice Phone: 314-542-2194
Practice Fax: 636-530-3015

1891389326 — MERCY PHARMACY SERVICES LLC
Practice Location Address:

12595 OLIVE BLVD
CREVE COEUR, MO
63141-6311

Practice Phone: 314-542-2194
Practice Fax: 636-530-3015

Directions to “ RACHEL DISTELRATH ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.