MEDICARE: MS. DEBORAH JOAN HOWARD LPTA

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	225200000X	Physical Therapy Assistant	5502001768	MI

General Provider Information

NPI Number	:	1922370824
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. DEBORAH JOAN HOWARD LPTA

Provider Business Mailing Address
First Line	:	10016 E C AVE
Second Line	:
City	:	RICHLAND
State	:	MI
Zip	:	49083-9584
Country	:	US
Telephone Number	:	269-569-8148
Fax Number	:

Provider Business Practice Location Address
First Line	:	10016 E C AVE
Second Line	:
City	:	RICHLAND
State	:	MI
Zip	:	49083-9584
Country	:	US
Telephone Number	:	269-569-8148
Fax Number	:

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

Provider Enumeration Date	:	02/08/2012
Last Update Date	:	02/08/2012

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