Healthcare Provider Details

I. General information

NPI: 1841426434
Provider Name (Legal Business Name): REBECCA ADDITON VELTRI DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/09/2009
Last Update Date: 10/28/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

32513 JOSEPH LN
PHILOMATH OR
97370-9130
US

IV. Provider business mailing address

5060 SW PHILOMATH BLVD #315
CORVALLIS OR
97333-3239
US

V. Phone/Fax

Practice location:
  • Phone: 617-519-0936
  • Fax:
Mailing address:
  • Phone: 617-519-0936
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251P0200X
TaxonomyPediatric Physical Therapist
License Number6360
License Number StateOR

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: