Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist |
NPI | 1003116773 |
---|---|
Provider Name | Rebecca Marie Pitts |
First Address | Santa Monica, CA 90403-5608 |
Second Address | Santa Monica, CA 90403-5608 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/10/2010 |
Last Update Date | 28/09/2021 |