Healthcare Provider Details

I. General information

NPI: 1023294014
Provider Name (Legal Business Name): REBECCA LYNN THOMANN P.T.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/21/2008
Last Update Date: 01/21/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1515 N ALEXANDRIA AVE
LOS ANGELES CA
90027-5203
US

IV. Provider business mailing address

105 PHEASANT RUN RD
ARGYLE TX
76226-9789
US

V. Phone/Fax

Practice location:
  • Phone: 323-660-1800
  • Fax:
Mailing address:
  • Phone: 210-862-2856
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number34391
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number1162586
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: