Provider Demographics
NPI:1942412010
Name:SWEEZEY, REBECCA VAN DYKE (MPT)
Entity Type:Individual
Prefix:MRS
First Name:REBECCA
Middle Name:VAN DYKE
Last Name:SWEEZEY
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3319 DR JOHN HAYNES DR
Mailing Address - Street 2:STE 4
Mailing Address - City:PELL CITY
Mailing Address - State:AL
Mailing Address - Zip Code:35125-1583
Mailing Address - Country:US
Mailing Address - Phone:205-338-8440
Mailing Address - Fax:
Practice Address - Street 1:3319 DR JOHN HAYNES DR
Practice Address - Street 2:STE 4
Practice Address - City:PELL CITY
Practice Address - State:AL
Practice Address - Zip Code:35125-1583
Practice Address - Country:US
Practice Address - Phone:205-338-8440
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-03
Last Update Date:2008-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALPTH 2995225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL515-38621OtherCFI BCBS
AL515-38622OtherMCB BCBS
AL510-93981OtherSCR BCBS
AL515-38622OtherMCB BCBS