Provider Demographics
NPI:1982030284
Name:PALMER, REBEKAH KATHLEEN (ATC)
Entity Type:Individual
Prefix:MRS
First Name:REBEKAH
Middle Name:KATHLEEN
Last Name:PALMER
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3725 N FLOWING WELLS RD
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85705-3022
Mailing Address - Country:US
Mailing Address - Phone:605-360-8913
Mailing Address - Fax:520-690-2330
Practice Address - Street 1:3725 N FLOWING WELLS RD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85705-3022
Practice Address - Country:US
Practice Address - Phone:605-360-8913
Practice Address - Fax:520-690-2330
Is Sole Proprietor?:No
Enumeration Date:2013-09-18
Last Update Date:2013-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ10982255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer