Provider Demographics
NPI:1902510282
Name:DULIS, REBECCA MARIA (PT, DPT, CSCS)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:MARIA
Last Name:DULIS
Suffix:
Gender:F
Credentials:PT, DPT, CSCS
Other - Prefix:
Other - First Name:REBECCA
Other - Middle Name:MARIA
Other - Last Name:BENZER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3370 W GOLDEN LN
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85226-1442
Mailing Address - Country:US
Mailing Address - Phone:480-208-0884
Mailing Address - Fax:
Practice Address - Street 1:2051 S DOBSON RD STE 1
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85202-6433
Practice Address - Country:US
Practice Address - Phone:480-573-0528
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-11
Last Update Date:2023-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ32790225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist