Provider Demographics
NPI:1114144557
Name:BEARS, RACHEL LEE (MPT)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:LEE
Last Name:BEARS
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:RACHEL
Other - Middle Name:LEE
Other - Last Name:EINERSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:105 S JEFFERSON ST
Mailing Address - Street 2:SUITE B5
Mailing Address - City:KEARNEY
Mailing Address - State:MO
Mailing Address - Zip Code:64060-8503
Mailing Address - Country:US
Mailing Address - Phone:816-903-0775
Mailing Address - Fax:816-903-0776
Practice Address - Street 1:105 S JEFFERSON ST
Practice Address - Street 2:SUITE B5
Practice Address - City:KEARNEY
Practice Address - State:MO
Practice Address - Zip Code:64060-8503
Practice Address - Country:US
Practice Address - Phone:816-903-0775
Practice Address - Fax:816-903-0776
Is Sole Proprietor?:No
Enumeration Date:2007-04-19
Last Update Date:2008-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2007021000225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO38954024OtherBCBS
MO38954014OtherBCBS
MOW12F379Medicare PIN
MOP75F379Medicare PIN