Provider Demographics
NPI:1194163741
Name:POUNDS, REBEKAH JANE (DPT)
Entity type:Individual
Prefix:DR
First Name:REBEKAH
Middle Name:JANE
Last Name:POUNDS
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:MS
Other - First Name:REBEKAH
Other - Middle Name:JANE
Other - Last Name:MCCLELLAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSPT
Mailing Address - Street 1:1517 PIN OAK CT APT A
Mailing Address - Street 2:
Mailing Address - City:ROLLA
Mailing Address - State:MO
Mailing Address - Zip Code:65401-9306
Mailing Address - Country:US
Mailing Address - Phone:417-766-6715
Mailing Address - Fax:
Practice Address - Street 1:1517 PIN OAK CT APT A
Practice Address - Street 2:
Practice Address - City:ROLLA
Practice Address - State:MO
Practice Address - Zip Code:65401-9306
Practice Address - Country:US
Practice Address - Phone:417-766-6715
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-05
Last Update Date:2013-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2005013899225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist