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NPI 1336505676

NPI 1336505676 : MRS. REBECCA SPIKER : ANNAPOLIS, MD

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General NPI Number Information
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    NPI Number           |    1336505676
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    Entity Type          |    Individual 
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    Provider Name        |    MRS. REBECCA SPIKER
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    12/31/2015
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    Last Update Date     |    11/15/2023
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Provider Practice Location Address
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    Address Line         |    1834 GEORGE AVE 
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    City                 |    ANNAPOLIS
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    State                |    MD
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    Zip                  |    21401-4103
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    Country              |    US
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    Telephone            |    443-441-0631
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    1222 JUNIPER ST 
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    City                 |    SHADY SIDE
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    State                |    MD
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    Zip                  |    20764-9219
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    Country              |    US
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    Telephone            |    410-474-8475
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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       |    A0000877
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    License Number State |    MD
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Taxonomy #2
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    Taxonomy Code        |    225100000X
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    Taxonomy Name        |    Physical Therapist
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    License Number       |    28767
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    License Number State |    MD
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