Individual
REBECCA JACEWICZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
12220 E RIGGS RD STE 101, CHANDLER, AZ 85249
(480) 895-0965
Mailing address
4960 S GILBERT RD STE 1-138, CHANDLER, AZ 85249-6003
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6729
LICENSE#
AZ
Enumeration date
08/28/2006
Last updated
08/27/2019
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