Individual
REBECCA REGINA RIVERA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
401 INDIANA AVE, MAYFIELD, KY 42066-1766
(270) 247-0200
Mailing address
401 INDIANA AVE, MAYFIELD, KY 42066-1766
(270) 247-0200
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
00002565
KY
Other
Enumeration date
12/05/2017
Last updated
12/05/2017
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