Provider Demographics
NPI:1194573253
Name:LUCK, REBECCA (PT, DPT)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:LUCK
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 RETREAT DR
Mailing Address - Street 2:
Mailing Address - City:SUFFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23435-1657
Mailing Address - Country:US
Mailing Address - Phone:443-822-4288
Mailing Address - Fax:
Practice Address - Street 1:4030 REMINGTON OAKS CIR
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27519-8748
Practice Address - Country:US
Practice Address - Phone:443-822-4288
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-13
Last Update Date:2024-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist