MEDICARE: MRS. DEBBIE K PRESTON M.S., 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
1	225100000X	Physical Therapist	05001858A	IN

General Provider Information

NPI Number	:	1932185832
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. DEBBIE K PRESTON M.S., P.T.

Provider Business Mailing Address
First Line	:	70 E 91ST ST
Second Line	:	STE 100
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46240-1550
Country	:	US
Telephone Number	:	317-574-1140
Fax Number	:	317-574-1141

Provider Business Practice Location Address
First Line	:	70 E 91ST ST
Second Line	:	SUITE 100
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46240-1550
Country	:	US
Telephone Number	:	317-574-1140
Fax Number	:	317-574-1141

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/22/2005
Last Update Date	:	02/13/2008

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