Provider Demographics
NPI:1467616078
Name:GASKINS, DEBORAH (PTA)
Entity Type:Individual
Prefix:MISS
First Name:DEBORAH
Middle Name:
Last Name:GASKINS
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1215 HIGHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:TRENT WOODS
Mailing Address - State:NC
Mailing Address - Zip Code:28562-5831
Mailing Address - Country:US
Mailing Address - Phone:252-637-4017
Mailing Address - Fax:
Practice Address - Street 1:1215 HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:TRENT WOODS
Practice Address - State:NC
Practice Address - Zip Code:28562-5831
Practice Address - Country:US
Practice Address - Phone:252-637-4017
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-12
Last Update Date:2008-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC317225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant