Provider Demographics
NPI:1912329178
Name:WORKMAN, REBECCA V (PT)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:V
Last Name:WORKMAN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:REBECCA
Other - Middle Name:
Other - Last Name:RAINES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:3050 N LITCHFIELD RD
Mailing Address - Street 2:STE 100
Mailing Address - City:GOODYEAR
Mailing Address - State:AZ
Mailing Address - Zip Code:85395-7805
Mailing Address - Country:US
Mailing Address - Phone:623-935-5505
Mailing Address - Fax:
Practice Address - Street 1:9218 KIMMER DR
Practice Address - Street 2:SUITE 100
Practice Address - City:LONE TREE
Practice Address - State:CO
Practice Address - Zip Code:80124-6732
Practice Address - Country:US
Practice Address - Phone:303-792-7377
Practice Address - Fax:303-792-9077
Is Sole Proprietor?:No
Enumeration Date:2014-01-07
Last Update Date:2020-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPT-31318225100000X
COPTL0012450225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist