Provider Demographics
NPI:1477856375
Name:MANRING, REBECCA A (PT)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:A
Last Name:MANRING
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:245 BARCLAY CIR
Mailing Address - Street 2:STE 400
Mailing Address - City:ROCHESTER HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48307-5812
Mailing Address - Country:US
Mailing Address - Phone:586-991-0801
Mailing Address - Fax:
Practice Address - Street 1:51850 DEQUINDRE RD
Practice Address - Street 2:STE 1
Practice Address - City:SHELBY TWP
Practice Address - State:MI
Practice Address - Zip Code:48316-2806
Practice Address - Country:US
Practice Address - Phone:586-991-0801
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-15
Last Update Date:2017-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501009546225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist