Provider Demographics
NPI:1336796705
Name:MEYER-WARNER, REBECCA JOY (PT)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:JOY
Last Name:MEYER-WARNER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:REBECCCA
Other - Middle Name:JOY
Other - Last Name:MEYER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:341 COOK RD
Mailing Address - Street 2:
Mailing Address - City:MILLERTON
Mailing Address - State:PA
Mailing Address - Zip Code:16936-9285
Mailing Address - Country:US
Mailing Address - Phone:717-891-1404
Mailing Address - Fax:
Practice Address - Street 1:32-36 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:WELLSBORO
Practice Address - State:PA
Practice Address - Zip Code:16901-1899
Practice Address - Country:US
Practice Address - Phone:570-723-0120
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-21
Last Update Date:2019-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT013426L225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist