Healthcare Provider Details

I. General information

NPI: 1174963011
Provider Name (Legal Business Name): DEBRA HOHN PT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: DEBRA BOWMAN

II. Dates (important events)

Enumeration Date: 06/25/2013
Last Update Date: 03/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

398 BLUE JAY DR
LIBERTY MO
64068-1977
US

IV. Provider business mailing address

2609 GLENN HENDERN DR
LIBERTY MO
64068
US

V. Phone/Fax

Practice location:
  • Phone: 816-407-2315
  • Fax: 816-407-1555
Mailing address:
  • Phone: 816-407-4555
  • Fax: 816-781-6973

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number1104599
License Number StateKS
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number2013033842
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: