Provider Demographics
NPI:1629283700
Name:EAGLEEYE, REBECCA (MPT)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:EAGLEEYE
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16600 W SPRAGUE RD
Mailing Address - Street 2:STE 365
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44130-6318
Mailing Address - Country:US
Mailing Address - Phone:800-297-1479
Mailing Address - Fax:866-848-2496
Practice Address - Street 1:16600 W SPRAGUE RD
Practice Address - Street 2:STE 365
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44130-6318
Practice Address - Country:US
Practice Address - Phone:800-297-1479
Practice Address - Fax:866-848-2496
Is Sole Proprietor?:No
Enumeration Date:2007-05-11
Last Update Date:2012-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070013666225100000X
OH010190225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist