Provider Demographics
NPI:1386905784
Name:BAHRMASEL, REBECCA DIANE (DPT)
Entity type:Individual
Prefix:MISS
First Name:REBECCA
Middle Name:DIANE
Last Name:BAHRMASEL
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8340 N BROADWAY
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63147-2333
Mailing Address - Country:US
Mailing Address - Phone:314-385-9563
Mailing Address - Fax:
Practice Address - Street 1:8340 N BROADWAY
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63147-2333
Practice Address - Country:US
Practice Address - Phone:314-385-9563
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-01
Last Update Date:2012-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2012016549225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist