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General NPI Number Information
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NPI Number | 1114484607
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Entity Type | Individual
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Provider Name | REBEKKA LYNN GREENWALT
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Gender | Female
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Dates
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Enumeration Date | 02/21/2019
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Last Update Date | 02/21/2019
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Provider Practice Location Address
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Address Line | 2100 COLLEGE ST
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City | NEWBERRY
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State | SC
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Zip | 29108-2126
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Country | US
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Telephone | 803-321-3327
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Fax |
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Provider Business Mailing Address
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Address Line | 607 HAW CREEK MEWS PL
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City | ASHEVILLE
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State | NC
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Zip | 28805-7902
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Country | US
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Telephone | 321-917-9516
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number |
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License Number State |
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