Provider Demographics
NPI:1659675668
Name:KERR, DEBRA D (PTA)
Entity Type:Individual
Prefix:
First Name:DEBRA
Middle Name:D
Last Name:KERR
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 1:102 W BOTKIN ST
Mailing Address - Street 2:
Mailing Address - City:WELLINGTON
Mailing Address - State:KS
Mailing Address - Zip Code:67152-2302
Mailing Address - Country:US
Mailing Address - Phone:620-326-7437
Mailing Address - Fax:620-326-7421
Practice Address - Street 1:102 W BOTKIN ST
Practice Address - Street 2:
Practice Address - City:WELLINGTON
Practice Address - State:KS
Practice Address - Zip Code:67152-2302
Practice Address - Country:US
Practice Address - Phone:620-326-7437
Practice Address - Fax:620-326-7421
Is Sole Proprietor?:No
Enumeration Date:2011-01-05
Last Update Date:2011-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS14-00299225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant