Provider Demographics
NPI:1568699593
Name:REGT THERAPY & REHABILITION SERVICES,LTD.
Entity Type:Organization
Organization Name:REGT THERAPY & REHABILITION SERVICES,LTD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:EVEGLOWNIAK
Authorized Official - Last Name:TOKARCZYK
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:928-634-2938
Mailing Address - Street 1:PO BOX 3955
Mailing Address - Street 2:
Mailing Address - City:COTTONWOOD
Mailing Address - State:AZ
Mailing Address - Zip Code:86326-2610
Mailing Address - Country:US
Mailing Address - Phone:928-639-0166
Mailing Address - Fax:928-639-0167
Practice Address - Street 1:533 S MAIN ST
Practice Address - Street 2:
Practice Address - City:COTTONWOOD
Practice Address - State:AZ
Practice Address - Zip Code:86326-3902
Practice Address - Country:US
Practice Address - Phone:928-634-2938
Practice Address - Fax:866-230-9513
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-17
Last Update Date:2009-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ6207PT225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty