Provider Demographics
NPI:1588163331
Name:CHAMBERS, REBECCA (PT,DPT)
Entity type:Individual
Prefix:DR
First Name:REBECCA
Middle Name:
Last Name:CHAMBERS
Suffix:
Gender:F
Credentials:PT,DPT
Other - Prefix:
Other - First Name:REBECCA
Other - Middle Name:
Other - Last Name:HARDY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5A HUTCHINSON DR
Mailing Address - Street 2:
Mailing Address - City:DANVERS
Mailing Address - State:MA
Mailing Address - Zip Code:01923-3777
Mailing Address - Country:US
Mailing Address - Phone:978-750-8188
Mailing Address - Fax:
Practice Address - Street 1:1 MARKET ST STE 3
Practice Address - Street 2:
Practice Address - City:LYNN
Practice Address - State:MA
Practice Address - Zip Code:01901-1044
Practice Address - Country:US
Practice Address - Phone:781-592-0540
Practice Address - Fax:781-592-0989
Is Sole Proprietor?:No
Enumeration Date:2018-02-07
Last Update Date:2020-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA234642081S0010X, 225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2081S0010XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationSports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA9748521Medicaid