Provider Demographics
NPI:1144615204
Name:ZELENKO, REBECCA CATHERINE (MS, LAT/ATC)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:CATHERINE
Last Name:ZELENKO
Suffix:
Gender:F
Credentials:MS, LAT/ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 OPPORTUNITY BLVD S
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MN
Mailing Address - Zip Code:55008-2801
Mailing Address - Country:US
Mailing Address - Phone:920-599-0187
Mailing Address - Fax:
Practice Address - Street 1:1425 MAIN ST N
Practice Address - Street 2:
Practice Address - City:PINE CITY
Practice Address - State:MN
Practice Address - Zip Code:55063-6026
Practice Address - Country:US
Practice Address - Phone:320-629-6310
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-04-05
Last Update Date:2020-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN29142255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer