Provider Demographics
NPI:1356866040
Name:BROWN, REBECCA GENE (PTA)
Entity Type:Individual
Prefix:MRS
First Name:REBECCA
Middle Name:GENE
Last Name:BROWN
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2524 NORTH SUMMIT
Mailing Address - Street 2:
Mailing Address - City:ARKANSAS CITY
Mailing Address - State:KS
Mailing Address - Zip Code:67005
Mailing Address - Country:US
Mailing Address - Phone:620-442-0255
Mailing Address - Fax:620-442-0257
Practice Address - Street 1:2524 N SUMMIT ST
Practice Address - Street 2:
Practice Address - City:ARKANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:67005-8808
Practice Address - Country:US
Practice Address - Phone:620-442-0255
Practice Address - Fax:620-442-0257
Is Sole Proprietor?:No
Enumeration Date:2017-08-03
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS14-02805225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant