Provider Demographics
NPI:1386948750
Name:PEARSON, BECKY JEAN (PT)
Entity type:Individual
Prefix:
First Name:BECKY
Middle Name:JEAN
Last Name:PEARSON
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2021 SOUTH E ST.
Mailing Address - Street 2:SUITE 1
Mailing Address - City:BROKEN BOW
Mailing Address - State:NE
Mailing Address - Zip Code:68822-1848
Mailing Address - Country:US
Mailing Address - Phone:308-872-5800
Mailing Address - Fax:308-872-5803
Practice Address - Street 1:2021 SOUTH E ST.
Practice Address - Street 2:SUITE 1
Practice Address - City:BROKEN BOW
Practice Address - State:NE
Practice Address - Zip Code:68822-1848
Practice Address - Country:US
Practice Address - Phone:308-872-5800
Practice Address - Fax:308-872-5803
Is Sole Proprietor?:No
Enumeration Date:2010-12-29
Last Update Date:2014-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE2419225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist