Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 12313 | AZ |
N | 2251G0304X | Physical Therapist - Geriatrics | 12313 | AZ |
N | 2251N0400X | Physical Therapist - Neurology | 12313 | AZ |
N | 2251S0007X | Physical Therapist - Sports | 12313 | AZ |
N | 2251X0800X | Physical Therapist - Orthopedic | 12313 | AZ |
NPI | 1033607916 |
---|---|
Provider Name | Dr. Rebecca Lynn Patton |
First Address | Glendale, AZ 85305-3199 |
Second Address | Glendale, AZ 85305-3199 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/04/2018 |
Last Update Date | 26/04/2018 |