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NPI Code Detail

MEDICARE: REBECCA THORNOCK

MEDICARE:   REBECCA  THORNOCK
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
1235Z00000XSpeech-Language Pathologist

General Provider Information

NPI Number : 1629680046
Entity Type Code : Individual
Provider Name (Legal Business Name) : REBECCA THORNOCK
Provider Business Mailing Address
First Line : 2048 N BOYSENBERRY DR
Second Line :
City : SARATOGA SPRINGS
State : UT
Zip : 84045-8205
Country : US
Telephone Number : 801-473-9009
Fax Number :
Provider Business Practice Location Address
First Line : 2048 N BOYSENBERRY DR
Second Line :
City : SARATOGA SPRINGS
State : UT
Zip : 84045-8205
Country : US
Telephone Number : 801-473-9009
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/18/2020
Last Update Date : 08/18/2020

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Directions to “ REBECCA THORNOCK ” Practice Location

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