Healthcare Provider Details

I. General information

NPI: 1326776220
Provider Name (Legal Business Name): REBEKAH ANN CAIN PTA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/10/2022
Last Update Date: 08/10/2022
Certification Date: 08/10/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

118 MEDICAL DR
CARMEL IN
46032-3323
US

IV. Provider business mailing address

814 LILLY LN
JEFFERSONVILLE IN
47130-4947
US

V. Phone/Fax

Practice location:
  • Phone: 502-494-1627
  • Fax:
Mailing address:
  • Phone: 502-494-1627
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number06005780A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: