Provider Demographics
NPI:1518654052
Name:RAMOS, REBEKKA ELISABETH (PTA)
Entity Type:Individual
Prefix:
First Name:REBEKKA
Middle Name:ELISABETH
Last Name:RAMOS
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:PO BOX 6370
Mailing Address - Street 2:
Mailing Address - City:WEST COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29171-6370
Mailing Address - Country:US
Mailing Address - Phone:803-238-8504
Mailing Address - Fax:
Practice Address - Street 1:700 DAVEGA DR
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:SC
Practice Address - Zip Code:29073-9698
Practice Address - Country:US
Practice Address - Phone:803-369-8127
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-24
Last Update Date:2023-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC4406225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant