Provider Demographics
NPI:1801275433
Name:WEEKS, REBECCA (LAC)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:WEEKS
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:435 HAIKU RD
Mailing Address - Street 2:
Mailing Address - City:HAIKU
Mailing Address - State:HI
Mailing Address - Zip Code:96708-5882
Mailing Address - Country:US
Mailing Address - Phone:720-933-2713
Mailing Address - Fax:
Practice Address - Street 1:810 KOKOMO RD STE 158
Practice Address - Street 2:
Practice Address - City:HAIKU
Practice Address - State:HI
Practice Address - Zip Code:96708-5876
Practice Address - Country:US
Practice Address - Phone:720-933-2713
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-05-28
Last Update Date:2015-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIACU-1098171100000X
COACU.0001821171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist