Provider Demographics
NPI:1861706293
Name:LAPHAM, REBECCA DAWN (DC)
Entity type:Individual
Prefix:DR
First Name:REBECCA
Middle Name:DAWN
Last Name:LAPHAM
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3366 CYPRESS MILL RD
Mailing Address - Street 2:
Mailing Address - City:BRUNSWICK
Mailing Address - State:GA
Mailing Address - Zip Code:31520-2851
Mailing Address - Country:US
Mailing Address - Phone:912-262-9735
Mailing Address - Fax:912-262-9634
Practice Address - Street 1:3366 CYPRESS MILL RD
Practice Address - Street 2:
Practice Address - City:BRUNSWICK
Practice Address - State:GA
Practice Address - Zip Code:31520-2851
Practice Address - Country:US
Practice Address - Phone:912-262-9735
Practice Address - Fax:912-262-9634
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-27
Last Update Date:2010-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR008674111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor