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General NPI Number Information
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NPI Number | 1427234749
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Entity Type | Individual
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Provider Name | REBECCA LYNN GARDNER-REILLY MPT
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Gender | Female
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Dates
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Enumeration Date | 01/16/2008
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Last Update Date | 12/15/2025
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Provider Practice Location Address
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Address Line | 19349 HIGHLAND DR
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City | NEW BUFFALO
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State | MI
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Zip | 49117-8942
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Country | US
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Telephone | 269-205-3669
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Fax | 269-238-3771
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Provider Business Mailing Address
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Address Line | 19349 HIGHLAND DR
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City | NEW BUFFALO
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State | MI
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Zip | 49117-8942
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Country | US
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Telephone | 773-824-6306
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Fax | 269-238-3771
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 5501302457
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License Number State | MI
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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 | 05015174A
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License Number State | IN
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