Healthcare Provider Details

I. General information

NPI: 1336120781
Provider Name (Legal Business Name): REBECCA SUSAN TINSMAN PT, OCS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/10/2005
Last Update Date: 06/15/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

256 FOX HUNT DR
BEAR DE
19701-2536
US

IV. Provider business mailing address

256 FOX HUNT DR
BEAR DE
19701-2536
US

V. Phone/Fax

Practice location:
  • Phone: 302-834-8650
  • Fax: 302-834-8698
Mailing address:
  • Phone: 302-834-8650
  • Fax: 302-834-8698

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberJ10001454
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: