Provider Demographics
NPI:1265559041
Name:TUFTS, REBECCA MAY (PTA)
Entity type:Individual
Prefix:MRS
First Name:REBECCA
Middle Name:MAY
Last Name:TUFTS
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:MISS
Other - First Name:REBECCA
Other - Middle Name:MAY
Other - Last Name:MAHOSKY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PTA
Mailing Address - Street 1:119 W HIGH ST
Mailing Address - Street 2:
Mailing Address - City:WOODBURY
Mailing Address - State:TN
Mailing Address - Zip Code:37190-1226
Mailing Address - Country:US
Mailing Address - Phone:615-563-5939
Mailing Address - Fax:
Practice Address - Street 1:119 W HIGH ST
Practice Address - Street 2:
Practice Address - City:WOODBURY
Practice Address - State:TN
Practice Address - Zip Code:37190-1226
Practice Address - Country:US
Practice Address - Phone:615-563-5939
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-25
Last Update Date:2019-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNPTA0000004625208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation