Provider Demographics
NPI:1760606412
Name:BYERLEY, REBECCA JEANETTE (PT)
Entity Type:Individual
Prefix:MRS
First Name:REBECCA
Middle Name:JEANETTE
Last Name:BYERLEY
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:PO BOX 2741
Mailing Address - Street 2:
Mailing Address - City:SOLDOTNA
Mailing Address - State:AK
Mailing Address - Zip Code:99669-2741
Mailing Address - Country:US
Mailing Address - Phone:907-260-5990
Mailing Address - Fax:866-356-3029
Practice Address - Street 1:104 S BINKLEY ST
Practice Address - Street 2:SUITE C
Practice Address - City:SOLDOTNA
Practice Address - State:AK
Practice Address - Zip Code:99669-8006
Practice Address - Country:US
Practice Address - Phone:907-260-5990
Practice Address - Fax:866-356-3029
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK1014225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist