Provider Demographics
NPI:1831270776
Name:MOKRIS, REBECCA L (DED, LAT)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:L
Last Name:MOKRIS
Suffix:
Gender:F
Credentials:DED, LAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:503 W ARLINGTON RD
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16509-2205
Mailing Address - Country:US
Mailing Address - Phone:814-434-7933
Mailing Address - Fax:
Practice Address - Street 1:109 UNIVERSITY SQ
Practice Address - Street 2:MOROSKY COLLEGE OF HEALTH PROFESSIONS AND COLLEGES M164
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16541-0001
Practice Address - Country:US
Practice Address - Phone:814-434-7933
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-18
Last Update Date:2014-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PART0035162255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer