Provider Demographics
NPI:1336458884
Name:STONE, REBECCA (MPT)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:STONE
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20917 N 55TH AVE
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85308-9128
Mailing Address - Country:US
Mailing Address - Phone:602-320-0880
Mailing Address - Fax:
Practice Address - Street 1:7430 E PINNACLE PEAK RD
Practice Address - Street 2:ST 138
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85255-3630
Practice Address - Country:US
Practice Address - Phone:480-502-4324
Practice Address - Fax:480-502-1397
Is Sole Proprietor?:No
Enumeration Date:2010-10-01
Last Update Date:2013-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ9052225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ141541Medicare PIN