Provider Demographics
NPI:1518536341
Name:CHRISTOFFERSEN, REBEKAH DARLENE (DPT)
Entity Type:Individual
Prefix:
First Name:REBEKAH
Middle Name:DARLENE
Last Name:CHRISTOFFERSEN
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4319 NW URBANDALE DR
Mailing Address - Street 2:
Mailing Address - City:URBANDALE
Mailing Address - State:IA
Mailing Address - Zip Code:50322-7910
Mailing Address - Country:US
Mailing Address - Phone:515-225-4070
Mailing Address - Fax:
Practice Address - Street 1:4319 NW URBANDALE DR
Practice Address - Street 2:
Practice Address - City:URBANDALE
Practice Address - State:IA
Practice Address - Zip Code:50322-7910
Practice Address - Country:US
Practice Address - Phone:515-225-4070
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-24
Last Update Date:2021-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist