Provider Demographics
NPI:1790973287
Name:PEARSON-PHILLIPS, REBECCA ANN (DIPL AC, LAC,)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:ANN
Last Name:PEARSON-PHILLIPS
Suffix:
Gender:F
Credentials:DIPL AC, LAC,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:239 PARK AVE
Mailing Address - Street 2:
Mailing Address - City:PINE
Mailing Address - State:CO
Mailing Address - Zip Code:80470-9120
Mailing Address - Country:US
Mailing Address - Phone:720-271-5113
Mailing Address - Fax:303-816-0025
Practice Address - Street 1:239 PARK AVE
Practice Address - Street 2:
Practice Address - City:PINE
Practice Address - State:CO
Practice Address - Zip Code:80470-9120
Practice Address - Country:US
Practice Address - Phone:720-271-5113
Practice Address - Fax:303-816-0025
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-09
Last Update Date:2007-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1327171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist