Provider Demographics
NPI:1043558935
Name:DUNBAR, REBECCA STORY
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:STORY
Last Name:DUNBAR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 63113
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80962-3113
Mailing Address - Country:US
Mailing Address - Phone:719-247-8916
Mailing Address - Fax:719-247-8930
Practice Address - Street 1:16055 OLD FOREST PT
Practice Address - Street 2:SUITE 101B
Practice Address - City:MONUMENT
Practice Address - State:CO
Practice Address - Zip Code:80132-8670
Practice Address - Country:US
Practice Address - Phone:719-247-8916
Practice Address - Fax:719-247-8930
Is Sole Proprietor?:No
Enumeration Date:2013-01-28
Last Update Date:2013-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO8499225100000X, 2251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist