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General NPI Number Information
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NPI Number | 1821674623
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Entity Type | Individual
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Provider Name | REBECCA LEIBRICK
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Gender | Female
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Dates
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Enumeration Date | 03/22/2021
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Last Update Date | 03/22/2021
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Provider Practice Location Address
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Address Line | 2660 REIDVILLE RD STE 6&7
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City | SPARTANBURG
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State | SC
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Zip | 29301-3512
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Country | US
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Telephone | 864-576-3738
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Fax |
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Provider Business Mailing Address
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Address Line | 790 REMINGTON BLVD
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City | BOLINGBROOK
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State | IL
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Zip | 60440-4909
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Country | US
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Telephone |
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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