Provider Demographics
NPI:1417539933
Name:WHITE, REBECCA A (PT, DPT, GCS)
Entity Type:Individual
Prefix:DR
First Name:REBECCA
Middle Name:A
Last Name:WHITE
Suffix:
Gender:F
Credentials:PT, DPT, GCS
Other - Prefix:
Other - First Name:REBECCA
Other - Middle Name:A
Other - Last Name:WILLIAMS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:19468 W 52ND DR
Mailing Address - Street 2:
Mailing Address - City:GOLDEN
Mailing Address - State:CO
Mailing Address - Zip Code:80403-2171
Mailing Address - Country:US
Mailing Address - Phone:303-717-1072
Mailing Address - Fax:
Practice Address - Street 1:7390 W EASTMAN PL
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80227-5039
Practice Address - Country:US
Practice Address - Phone:303-988-2848
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-23
Last Update Date:2021-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPTL.00127002251G0304X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251G0304XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGeriatrics