Healthcare Provider Details

I. General information

NPI: 1932010394
Provider Name (Legal Business Name): REBECCA EDWARDS PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/15/2026
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 HOSPITAL DR
COLUMBIA MO
65212-1000
US

IV. Provider business mailing address

3400 E FRANKLIN RD
HARTSBURG MO
65039-9552
US

V. Phone/Fax

Practice location:
  • Phone: 573-884-0667
  • Fax:
Mailing address:
  • Phone: 573-694-2560
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number2008023879
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: