Provider Demographics
NPI:1326581216
Name:TIPPINS, REBECCA MARSHALL (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:REBECCA
Middle Name:MARSHALL
Last Name:TIPPINS
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3901 UNIVERSITY BLVD S
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32216-4312
Mailing Address - Country:US
Mailing Address - Phone:904-345-7336
Mailing Address - Fax:
Practice Address - Street 1:14286 BEACH BLVD
Practice Address - Street 2:SUITE 34
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32250-1561
Practice Address - Country:US
Practice Address - Phone:904-345-7510
Practice Address - Fax:904-345-7540
Is Sole Proprietor?:No
Enumeration Date:2016-11-23
Last Update Date:2016-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT31987225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist