Provider Demographics
NPI:1184082331
Name:HILL, REBECCA ANN (PTA)
Entity type:Individual
Prefix:MISS
First Name:REBECCA
Middle Name:ANN
Last Name:HILL
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7606 CEDARCREST DR
Mailing Address - Street 2:
Mailing Address - City:LEO
Mailing Address - State:IN
Mailing Address - Zip Code:46765-9582
Mailing Address - Country:US
Mailing Address - Phone:260-710-1838
Mailing Address - Fax:
Practice Address - Street 1:169 N 200 E
Practice Address - Street 2:
Practice Address - City:COLUMBIA CITY
Practice Address - State:IN
Practice Address - Zip Code:46725-8895
Practice Address - Country:US
Practice Address - Phone:260-244-5133
Practice Address - Fax:260-244-5134
Is Sole Proprietor?:No
Enumeration Date:2016-02-03
Last Update Date:2016-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN06004683A225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant