Provider Demographics
NPI:1609438084
Name:THURSTON, REBECCA R (PT)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:R
Last Name:THURSTON
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 MOOSE RUN
Mailing Address - Street 2:
Mailing Address - City:BARRINGTON
Mailing Address - State:NH
Mailing Address - Zip Code:03825-5915
Mailing Address - Country:US
Mailing Address - Phone:603-664-9986
Mailing Address - Fax:
Practice Address - Street 1:7 RIVERWOODS DR
Practice Address - Street 2:
Practice Address - City:EXETER
Practice Address - State:NH
Practice Address - Zip Code:03833-4374
Practice Address - Country:US
Practice Address - Phone:603-772-4700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-05
Last Update Date:2019-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH1413225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist