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NPI Code Detail

MEDICARE: DEBORAH MCKINNEY PTA

MEDICARE: DEBORAH MCKINNEY PTA
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
1174400000XSpecialist06002508AIN

General Provider Information

NPI Number : 1639332869
Entity Type Code : Individual
Provider Name (Legal Business Name) : DEBORAH MCKINNEY PTA
Provider Business Mailing Address
First Line : 2222 MARGARET AVE
Second Line :
City : TERRE HAUTE
State : IN
Zip : 47802-3339
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2222 MARGARET AVE
Second Line :
City : TERRE HAUTE
State : IN
Zip : 47802-3339
Country : US
Telephone Number : 812-232-2223
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/08/2008
Last Update Date : 07/08/2008

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Directions to “ DEBORAH MCKINNEY PTA” Practice Location

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