Provider Demographics
NPI:1548802986
Name:BOEHS, RACHEAL (PTA)
Entity Type:Individual
Prefix:
First Name:RACHEAL
Middle Name:
Last Name:BOEHS
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:RACHEAL
Other - Middle Name:
Other - Last Name:BECKNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PTA
Mailing Address - Street 1:9307 CLINT AVE
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79119-6231
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1313 N HOBART ST
Practice Address - Street 2:
Practice Address - City:PAMPA
Practice Address - State:TX
Practice Address - Zip Code:79065-4121
Practice Address - Country:US
Practice Address - Phone:806-665-9700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-16
Last Update Date:2019-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2889225200000X
TX2145352225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant