Provider Demographics
NPI:1902156540
Name:MOORE, RACHEL LEA (DPT)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:LEA
Last Name:MOORE
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 1:20981 E SMOKY HILL RD STE A
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80015-5189
Mailing Address - Country:US
Mailing Address - Phone:720-870-8900
Mailing Address - Fax:
Practice Address - Street 1:20981 E SMOKY HILL RD STE A
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80015-5189
Practice Address - Country:US
Practice Address - Phone:720-870-8900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-11
Last Update Date:2019-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO11863225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist