Provider Demographics
NPI:1235548579
Name:DAMOS, RACHEL (DPT)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:
Last Name:DAMOS
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:722 N STATE HIGHWAY 47
Mailing Address - Street 2:SUITE A
Mailing Address - City:WARRENTON
Mailing Address - State:MO
Mailing Address - Zip Code:63383-1108
Mailing Address - Country:US
Mailing Address - Phone:636-456-8883
Mailing Address - Fax:636-456-8854
Practice Address - Street 1:722 N STATE HIGHWAY 47
Practice Address - Street 2:SUITE A
Practice Address - City:WARRENTON
Practice Address - State:MO
Practice Address - Zip Code:63383-1108
Practice Address - Country:US
Practice Address - Phone:636-456-8883
Practice Address - Fax:636-456-8854
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-12
Last Update Date:2014-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2014026918225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist