Provider Demographics
NPI:1477717809
Name:PETTIT, DEBORAH J (MPT)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:J
Last Name:PETTIT
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6099 FAIRFIELD RD
Mailing Address - Street 2:
Mailing Address - City:OXFORD
Mailing Address - State:OH
Mailing Address - Zip Code:45056-1507
Mailing Address - Country:US
Mailing Address - Phone:513-523-5363
Mailing Address - Fax:
Practice Address - Street 1:6099 FAIRFIELD RD
Practice Address - Street 2:
Practice Address - City:OXFORD
Practice Address - State:OH
Practice Address - Zip Code:45056-1507
Practice Address - Country:US
Practice Address - Phone:513-523-5363
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-15
Last Update Date:2008-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH09381225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist