Provider Demographics
NPI:1922119585
Name:SMITH, REBECCA A (PHYSICAL THERAPIST)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:A
Last Name:SMITH
Suffix:
Gender:F
Credentials:PHYSICAL THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1403 MILL RACE DRIVE
Mailing Address - Street 2:HEARTLAND REHABILITATION SERVICES
Mailing Address - City:SALEM
Mailing Address - State:VA
Mailing Address - Zip Code:24153
Mailing Address - Country:US
Mailing Address - Phone:540-444-0526
Mailing Address - Fax:540-444-0531
Practice Address - Street 1:126 MILL LN
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:VA
Practice Address - Zip Code:24153-3102
Practice Address - Country:US
Practice Address - Phone:540-387-4311
Practice Address - Fax:540-389-6212
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305001537225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist