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NPI Code Detail

MEDICARE: REBECCA GWEN PATTERSON PT

MEDICARE: REBECCA GWEN PATTERSON PT
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
1225100000XPhysical Therapist0850NV

General Provider Information

NPI Number : 1215712922
Entity Type Code : Individual
Provider Name (Legal Business Name) : REBECCA GWEN PATTERSON PT
Provider Business Mailing Address
First Line : PO BOX 2350
Second Line :
City : ROCKLIN
State : CA
Zip : 95677-8350
Country : US
Telephone Number : 866-839-6979
Fax Number : 916-913-5646
Provider Business Practice Location Address
First Line : 5955 EDMOND ST
Second Line :
City : LAS VEGAS
State : NV
Zip : 89118-2856
Country : US
Telephone Number : 866-839-6979
Fax Number : 916-913-5646
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/30/2023
Last Update Date : 08/30/2023

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