Provider Demographics
NPI:1528215803
Name:HASTINGS, DEBORAH (PTA)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:
Last Name:HASTINGS
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:PO BOX 6062
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44312-0062
Mailing Address - Country:US
Mailing Address - Phone:330-630-1860
Mailing Address - Fax:330-630-3198
Practice Address - Street 1:161 NORTHWEST AVE
Practice Address - Street 2:STE 104
Practice Address - City:TALLMADGE
Practice Address - State:OH
Practice Address - Zip Code:44278-1850
Practice Address - Country:US
Practice Address - Phone:330-630-1860
Practice Address - Fax:330-630-3198
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-19
Last Update Date:2008-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH06826225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant