Provider Demographics
NPI:1629734041
Name:HAVIS, REBECCA CATHERINE (PT, DPT)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:CATHERINE
Last Name:HAVIS
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18068 W 92ND LN UNIT 200
Mailing Address - Street 2:
Mailing Address - City:ARVADA
Mailing Address - State:CO
Mailing Address - Zip Code:80007-8162
Mailing Address - Country:US
Mailing Address - Phone:720-497-6140
Mailing Address - Fax:720-497-6710
Practice Address - Street 1:18068 W 92ND LN UNIT 200
Practice Address - Street 2:
Practice Address - City:ARVADA
Practice Address - State:CO
Practice Address - Zip Code:80007-8162
Practice Address - Country:US
Practice Address - Phone:720-497-6140
Practice Address - Fax:720-497-6710
Is Sole Proprietor?:No
Enumeration Date:2021-11-10
Last Update Date:2021-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO18031225100000X
225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist