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NPI Code Detail

MEDICARE: MRS. PATRA DAWN DEERE P.T.

MEDICARE: MRS. PATRA DAWN DEERE P.T.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical TherapistIL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1PD 04841205POTHERILEARLY INTERVENTION CRED

General Provider Information

NPI Number : 1497969901
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. PATRA DAWN DEERE P.T.
Provider Business Mailing Address
First Line : 101 E 9TH ST
Second Line :
City : PANA
State : IL
Zip : 62557-1716
Country : US
Telephone Number : 217-562-6328
Fax Number : 217-562-6281
Provider Business Practice Location Address
First Line : 101 E 9TH ST
Second Line :
City : PANA
State : IL
Zip : 62557-1716
Country : US
Telephone Number : 217-562-6328
Fax Number : 217-562-6281
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/10/2007
Last Update Date : 07/08/2007

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Directions to “ MRS. PATRA DAWN DEERE P.T.” Practice Location

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