Provider Demographics
NPI:1649080177
Name:ROTHERA, REBECCA
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:ROTHERA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:REBECCA
Other - Middle Name:
Other - Last Name:BREWER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7800 STEVENS MILL RD # L
Mailing Address - Street 2:
Mailing Address - City:STALLINGS
Mailing Address - State:NC
Mailing Address - Zip Code:28104-6111
Mailing Address - Country:US
Mailing Address - Phone:704-893-5050
Mailing Address - Fax:
Practice Address - Street 1:7800 STEVENS MILL RD # L
Practice Address - Street 2:
Practice Address - City:MATTHEWS
Practice Address - State:NC
Practice Address - Zip Code:28104-6111
Practice Address - Country:US
Practice Address - Phone:704-893-5050
Practice Address - Fax:704-893-5066
Is Sole Proprietor?:No
Enumeration Date:2025-01-08
Last Update Date:2025-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner