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NPI Code Detail

MEDICARE: REBECCA GRUCZA CARTER

MEDICARE: REBECCA GRUCZA CARTER
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225200000XPhysical Therapy AssistantP160039259WA

General Provider Information

NPI Number : 1063142685
Entity Type Code : Individual
Provider Name (Legal Business Name) : REBECCA GRUCZA CARTER
Provider Business Mailing Address
First Line : 2624 MCLEOD RD
Second Line :
City : BELLINGHAM
State : WA
Zip : 98225-1368
Country : US
Telephone Number : 360-543-3791
Fax Number :
Provider Business Practice Location Address
First Line : 20420 MARINE DR
Second Line :
City : STANWOOD
State : WA
Zip : 98292-6116
Country : US
Telephone Number : 360-652-2632
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/15/2022
Last Update Date : 06/15/2022

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Directions to “ REBECCA GRUCZA CARTER ” Practice Location

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