Provider Demographics
NPI:1235380775
Name:LITZINGER, REBECCA SUE (PT)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:SUE
Last Name:LITZINGER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:REBECCA
Other - Middle Name:SUE
Other - Last Name:PREMRO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:132 DEMAR BLVD
Mailing Address - Street 2:
Mailing Address - City:CANONSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15317-2216
Mailing Address - Country:US
Mailing Address - Phone:724-743-9177
Mailing Address - Fax:
Practice Address - Street 1:132 DEMAR BLVD
Practice Address - Street 2:
Practice Address - City:CANONSBURG
Practice Address - State:PA
Practice Address - Zip Code:15317-2216
Practice Address - Country:US
Practice Address - Phone:724-743-9177
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-02
Last Update Date:2008-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT 015590225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist