Provider Demographics
NPI:1366672768
Name:LAMAR, REBECCA H (PT, DPT)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:H
Last Name:LAMAR
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:REBECCA
Other - Middle Name:R
Other - Last Name:HATFIELD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT,DPT
Mailing Address - Street 1:7109 GREENLAWN RD
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40222-6516
Mailing Address - Country:US
Mailing Address - Phone:502-939-1210
Mailing Address - Fax:
Practice Address - Street 1:520 WOODLAKE DR
Practice Address - Street 2:
Practice Address - City:MT WASHINGTON
Practice Address - State:KY
Practice Address - Zip Code:40047-5123
Practice Address - Country:US
Practice Address - Phone:502-538-3172
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-20
Last Update Date:2019-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY005424225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist