Provider Demographics
NPI:1164244166
Name:EIRAS, REBECCA SALLIE (PTA)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:SALLIE
Last Name:EIRAS
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8202 PERSIA WAY
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37211-7077
Mailing Address - Country:US
Mailing Address - Phone:615-982-2289
Mailing Address - Fax:
Practice Address - Street 1:392 HARDING PL STE 103
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37211-9601
Practice Address - Country:US
Practice Address - Phone:157-126-5266
Practice Address - Fax:615-712-6573
Is Sole Proprietor?:No
Enumeration Date:2024-10-30
Last Update Date:2024-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN7003225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant