Healthcare Provider Details

I. General information

NPI: 1518170778
Provider Name (Legal Business Name): REBECCA ANN SEXTON PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/07/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

254 MAIN ST
CADIZ KY
42211-9153
US

IV. Provider business mailing address

40 CUNNINGHAM AVE
CADIZ KY
42211-7960
US

V. Phone/Fax

Practice location:
  • Phone: 270-522-2533
  • Fax:
Mailing address:
  • Phone: 931-302-5364
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number4549
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: