Provider Demographics
NPI:1245309939
Name:WITTMAN, REBEKAH ANN (DC)
Entity type:Individual
Prefix:DR
First Name:REBEKAH
Middle Name:ANN
Last Name:WITTMAN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:REBEKAH
Other - Middle Name:ANN
Other - Last Name:MEECE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2072 N COUNTY ROAD 700 W
Mailing Address - Street 2:
Mailing Address - City:RICHLAND
Mailing Address - State:IN
Mailing Address - Zip Code:47634-9480
Mailing Address - Country:US
Mailing Address - Phone:812-686-4192
Mailing Address - Fax:
Practice Address - Street 1:2072 N COUNTY ROAD 700 W
Practice Address - Street 2:
Practice Address - City:RICHLAND
Practice Address - State:IN
Practice Address - Zip Code:47634-9480
Practice Address - Country:US
Practice Address - Phone:812-686-4192
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-07
Last Update Date:2023-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY4829111NP0017X
IN08002444A111NP0017X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NP0017XChiropractic ProvidersChiropractorPediatric Chiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200801450Medicaid
IN266801Medicare PIN
KYV01990Medicare UPIN