Provider Demographics
NPI:1003909052
Name:GERBER, DEBRA L (DPT)
Entity Type:Individual
Prefix:DR
First Name:DEBRA
Middle Name:L
Last Name:GERBER
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4602 TENBY DR
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27455-1483
Mailing Address - Country:US
Mailing Address - Phone:336-386-3677
Mailing Address - Fax:
Practice Address - Street 1:122 N ELM ST
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27401
Practice Address - Country:US
Practice Address - Phone:336-334-5601
Practice Address - Fax:336-334-5657
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2018-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5891225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7211559Medicaid
NC1568686988Medicaid