Provider Demographics
NPI:1124743133
Name:MEACHUM, REBECCA (PT, DPT)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:MEACHUM
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:BECKY
Other - Middle Name:
Other - Last Name:MEACHUM
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:374 E 60 S
Mailing Address - Street 2:
Mailing Address - City:IVINS
Mailing Address - State:UT
Mailing Address - Zip Code:84738-5092
Mailing Address - Country:US
Mailing Address - Phone:435-531-3126
Mailing Address - Fax:
Practice Address - Street 1:168 N 100 E
Practice Address - Street 2:
Practice Address - City:ST GEORGE
Practice Address - State:UT
Practice Address - Zip Code:84770-2893
Practice Address - Country:US
Practice Address - Phone:307-258-1852
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-11
Last Update Date:2022-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT10399710-24012251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics