Provider Demographics
NPI:1891173035
Name:FITZPATRICK, REBECCA (DPT)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:FITZPATRICK
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:402 STEPHANIE AVE
Mailing Address - Street 2:
Mailing Address - City:RINCON
Mailing Address - State:GA
Mailing Address - Zip Code:31326-9692
Mailing Address - Country:US
Mailing Address - Phone:757-685-9156
Mailing Address - Fax:
Practice Address - Street 1:402 STEPHANIE AVE
Practice Address - Street 2:
Practice Address - City:RINCON
Practice Address - State:GA
Practice Address - Zip Code:31326-9692
Practice Address - Country:US
Practice Address - Phone:757-685-9156
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-05-07
Last Update Date:2016-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics