Provider Demographics
NPI:1811311269
Name:JANKINS, REBECCA R (DPT, PT)
Entity type:Individual
Prefix:MRS
First Name:REBECCA
Middle Name:R
Last Name:JANKINS
Suffix:
Gender:F
Credentials:DPT, PT
Other - Prefix:
Other - First Name:REBECCA
Other - Middle Name:R
Other - Last Name:DION
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:1 CREDIT UNION WAY FL 3
Mailing Address - Street 2:
Mailing Address - City:RANDOLPH
Mailing Address - State:MA
Mailing Address - Zip Code:02368-4633
Mailing Address - Country:US
Mailing Address - Phone:781-961-3370
Mailing Address - Fax:781-961-1291
Practice Address - Street 1:445 CENTRAL ST
Practice Address - Street 2:
Practice Address - City:STOUGHTON
Practice Address - State:MA
Practice Address - Zip Code:02072-1900
Practice Address - Country:US
Practice Address - Phone:781-341-1942
Practice Address - Fax:781-436-8554
Is Sole Proprietor?:No
Enumeration Date:2014-02-05
Last Update Date:2019-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA20589225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110101616AMedicaid
MA4801609OtherAETNA
MA051892OtherUHC-OPTUM