Provider Demographics
NPI:1336403971
Name:RAILSBACK, REBECCA LYNN (ATC, LAT, MSED)
Entity Type:Individual
Prefix:MRS
First Name:REBECCA
Middle Name:LYNN
Last Name:RAILSBACK
Suffix:
Gender:F
Credentials:ATC, LAT, MSED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6221 MAY DR
Mailing Address - Street 2:
Mailing Address - City:WACO
Mailing Address - State:TX
Mailing Address - Zip Code:76710-5643
Mailing Address - Country:US
Mailing Address - Phone:254-716-7133
Mailing Address - Fax:
Practice Address - Street 1:1400 COLLEGE DR
Practice Address - Street 2:
Practice Address - City:WACO
Practice Address - State:TX
Practice Address - Zip Code:76708-1402
Practice Address - Country:US
Practice Address - Phone:254-299-8848
Practice Address - Fax:254-299-8814
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-28
Last Update Date:2012-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAT40792255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer