Provider Demographics
NPI:1962639948
Name:COKER, RACHEL BETH (PT)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:BETH
Last Name:COKER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:123 MEDICAL DR STE B
Mailing Address - Street 2:
Mailing Address - City:PALESTINE
Mailing Address - State:TX
Mailing Address - Zip Code:75801-8508
Mailing Address - Country:US
Mailing Address - Phone:903-729-8616
Mailing Address - Fax:903-729-8618
Practice Address - Street 1:123 MEDICAL DR STE B
Practice Address - Street 2:
Practice Address - City:PALESTINE
Practice Address - State:TX
Practice Address - Zip Code:75801-8508
Practice Address - Country:US
Practice Address - Phone:903-729-8616
Practice Address - Fax:903-729-8618
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-17
Last Update Date:2009-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1188389225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist