Provider Demographics
NPI:1073743555
Name:PATTON, DEBORAH JILL (PT)
Entity Type:Individual
Prefix:MRS
First Name:DEBORAH
Middle Name:JILL
Last Name:PATTON
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5271 GETWELL ROAD
Mailing Address - Street 2:
Mailing Address - City:SOUTHAVEN,
Mailing Address - State:MS
Mailing Address - Zip Code:38672
Mailing Address - Country:US
Mailing Address - Phone:662-510-5694
Mailing Address - Fax:
Practice Address - Street 1:5271 GETWELL RD
Practice Address - Street 2:
Practice Address - City:SOUTHAVEN
Practice Address - State:MS
Practice Address - Zip Code:38672-9608
Practice Address - Country:US
Practice Address - Phone:662-510-5694
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-20
Last Update Date:2009-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSPT1119225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist