Provider Demographics
NPI:1295070076
Name:GIBBS, REBEKAH SUZANNE (PT, DPT)
Entity type:Individual
Prefix:MRS
First Name:REBEKAH
Middle Name:SUZANNE
Last Name:GIBBS
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:REBEKAH
Other - Middle Name:SUZANNE
Other - Last Name:MAST
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:13055 W MCDOWELL RD
Mailing Address - Street 2:#G-107
Mailing Address - City:AVONDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85392-6449
Mailing Address - Country:US
Mailing Address - Phone:623-547-4787
Mailing Address - Fax:623-547-4788
Practice Address - Street 1:13055 W MCDOWELL RD
Practice Address - Street 2:#G-107
Practice Address - City:AVONDALE
Practice Address - State:AZ
Practice Address - Zip Code:85392-6449
Practice Address - Country:US
Practice Address - Phone:623-547-4787
Practice Address - Fax:623-547-4788
Is Sole Proprietor?:No
Enumeration Date:2012-12-04
Last Update Date:2025-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPT-010098225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist