Provider Demographics
NPI:1255716049
Name:GARCIA, REBECCA (RMT)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:GARCIA
Suffix:
Gender:F
Credentials:RMT
Other - Prefix:
Other - First Name:BECKY
Other - Middle Name:
Other - Last Name:GARCIA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RMT
Mailing Address - Street 1:1229 78TH AVE
Mailing Address - Street 2:
Mailing Address - City:GREELEY
Mailing Address - State:CO
Mailing Address - Zip Code:80634-8868
Mailing Address - Country:US
Mailing Address - Phone:970-402-1067
Mailing Address - Fax:
Practice Address - Street 1:601 MAIN ST
Practice Address - Street 2:
Practice Address - City:WINDSOR
Practice Address - State:CO
Practice Address - Zip Code:80550-5134
Practice Address - Country:US
Practice Address - Phone:970-402-1067
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-22
Last Update Date:2016-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0000760225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist