Gonzales, Rebekah Jo

Gonzales, Rebekah Jo is an individual health care provider with primary practice located at 603 N Grand Ave , Tahlequah OK 74464-2302. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Athletic Trainer, which is considered as her primary health care specialty. Gonzales, Rebekah Jo can be contacted via phone (918) 557-8232.

Contact Information

Primary practice address
603 N Grand Ave Tahlequah OK 74464-2302
Phone: (918) 557-8232
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Athletic Trainer 2255A2300X 862 Oklahoma

Profile Details

NPI number 1801273388
LBN Legal business name Gonzales, Rebekah Jo
Credentials ATC, LAT
Entity Individual
Sole proprietor 1 No
Enumeration date May 4th, 2015
Last updated May 4th, 2015 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1801273388 NPPES
Oklahoma Other 862 BOARD OF MEDICAL LICENSURE AND SUPERVISION
Oklahoma Other 63472 BOARD OF MEDICAL LICENSURE AND SUPERVISION

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