Provider Demographics
NPI:1023363728
Name:FALKNER, REBEKA LEIGH (DC)
Entity Type:Individual
Prefix:
First Name:REBEKA
Middle Name:LEIGH
Last Name:FALKNER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1830S ALMA SCHOOL RD 135
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85210-3088
Mailing Address - Country:US
Mailing Address - Phone:480-222-2129
Mailing Address - Fax:480-907-3061
Practice Address - Street 1:1830S ALMA SCHOOL RD 135
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85210-3088
Practice Address - Country:US
Practice Address - Phone:480-222-2129
Practice Address - Fax:480-907-3061
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-18
Last Update Date:2015-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ5042111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZU37337Medicare UPIN
AZ20130Medicare PIN