Provider Demographics
NPI:1568772887
Name:MANN, DEBRA BAXTER (PT)
Entity Type:Individual
Prefix:
First Name:DEBRA
Middle Name:BAXTER
Last Name:MANN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:DEBRA
Other - Middle Name:ANNE
Other - Last Name:BAXTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:84 COLD HILL ROAD
Mailing Address - Street 2:
Mailing Address - City:MENDHAM
Mailing Address - State:NJ
Mailing Address - Zip Code:07945-0001
Mailing Address - Country:US
Mailing Address - Phone:973-543-2500
Mailing Address - Fax:
Practice Address - Street 1:84 COLD HILL RD.
Practice Address - Street 2:
Practice Address - City:MENDHAM
Practice Address - State:NJ
Practice Address - Zip Code:07945-0000
Practice Address - Country:US
Practice Address - Phone:973-543-2500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-10-20
Last Update Date:2010-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA00348500172M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172M00000XOther Service ProvidersMechanotherapist