Provider Demographics
NPI:1548405921
Name:MCELROY, DEBBIE MARLENE (PTA)
Entity Type:Individual
Prefix:MRS
First Name:DEBBIE
Middle Name:MARLENE
Last Name:MCELROY
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 1:11623 ARBOR ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68144-2981
Mailing Address - Country:US
Mailing Address - Phone:800-334-1919
Mailing Address - Fax:402-334-6844
Practice Address - Street 1:605 HIGHWAY 432
Practice Address - Street 2:
Practice Address - City:OSKALOOSA
Practice Address - State:IA
Practice Address - Zip Code:52577-4700
Practice Address - Country:US
Practice Address - Phone:641-676-3414
Practice Address - Fax:641-676-3415
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-12
Last Update Date:2008-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA00636225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant