Provider Demographics
NPI:1689120933
Name:FLETCHER, RACHAEL (PT, DPT, ATC)
Entity type:Individual
Prefix:
First Name:RACHAEL
Middle Name:
Last Name:FLETCHER
Suffix:
Gender:F
Credentials:PT, DPT, ATC
Other - Prefix:
Other - First Name:RACHAEL
Other - Middle Name:
Other - Last Name:SCHMIDT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, DPT, ATC
Mailing Address - Street 1:1739 ELM CT
Mailing Address - Street 2:STE 205206
Mailing Address - City:JEFFERSON CITY
Mailing Address - State:MO
Mailing Address - Zip Code:65101-4303
Mailing Address - Country:US
Mailing Address - Phone:573-592-6592
Mailing Address - Fax:
Practice Address - Street 1:850 W HOSPITAL DR
Practice Address - Street 2:SUITE A
Practice Address - City:FULTON
Practice Address - State:MO
Practice Address - Zip Code:65251
Practice Address - Country:US
Practice Address - Phone:573-592-6592
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-28
Last Update Date:2019-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer