Provider Demographics
NPI:1053840363
Name:MACGREGOR, RACHAEL GRACE (DPT, DMT, FAAOMPT)
Entity Type:Individual
Prefix:DR
First Name:RACHAEL
Middle Name:GRACE
Last Name:MACGREGOR
Suffix:
Gender:F
Credentials:DPT, DMT, FAAOMPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16782 BABLER VIEW DR
Mailing Address - Street 2:
Mailing Address - City:WILDWOOD
Mailing Address - State:MO
Mailing Address - Zip Code:63011-1817
Mailing Address - Country:US
Mailing Address - Phone:314-302-6232
Mailing Address - Fax:
Practice Address - Street 1:16782 BABLER VIEW DR
Practice Address - Street 2:
Practice Address - City:WILDWOOD
Practice Address - State:MO
Practice Address - Zip Code:63011-1817
Practice Address - Country:US
Practice Address - Phone:314-302-6232
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-08
Last Update Date:2022-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2017018163225100000X, 225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist