Provider Demographics
NPI:1922368554
Name:EPPERSON, REBECCA TILSON (DPT)
Entity Type:Individual
Prefix:DR
First Name:REBECCA
Middle Name:TILSON
Last Name:EPPERSON
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:DR
Other - First Name:REBECCA
Other - Middle Name:E
Other - Last Name:TILSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:410 NEW BRIDGE ST
Mailing Address - Street 2:SUITE 10A
Mailing Address - City:JACKSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28540-4739
Mailing Address - Country:US
Mailing Address - Phone:910-347-2212
Mailing Address - Fax:910-378-1747
Practice Address - Street 1:410 NEW BRIDGE ST
Practice Address - Street 2:SUITE 10A
Practice Address - City:JACKSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28540-4739
Practice Address - Country:US
Practice Address - Phone:910-347-2212
Practice Address - Fax:910-378-1747
Is Sole Proprietor?:No
Enumeration Date:2012-05-16
Last Update Date:2014-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI3383225100000X
NC148152251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist