Healthcare Provider Details

I. General information

NPI: 1124584487
Provider Name (Legal Business Name): REBEKAH WILKS DC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/12/2019
Last Update Date: 09/22/2026
Certification Date: 09/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10023 ADDISON WAY APT 8414
SEMINOLE FL
33772-6080
US

IV. Provider business mailing address

10023 ADDISON WAY APT 8414
SEMINOLE FL
33772-6080
US

V. Phone/Fax

Practice location:
  • Phone: 806-928-6527
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number60922973
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number5973
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: