Provider Demographics
NPI:1730470519
Name:HILL, DEBRA SUE (CPTA)
Entity Type:Individual
Prefix:MRS
First Name:DEBRA
Middle Name:SUE
Last Name:HILL
Suffix:
Gender:F
Credentials:CPTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 CEDAR ST
Mailing Address - Street 2:
Mailing Address - City:CEDAR VALE
Mailing Address - State:KS
Mailing Address - Zip Code:67024-8901
Mailing Address - Country:US
Mailing Address - Phone:620-545-5501
Mailing Address - Fax:620-725-3779
Practice Address - Street 1:613 E ELM ST
Practice Address - Street 2:
Practice Address - City:SEDAN
Practice Address - State:KS
Practice Address - Zip Code:67361-1406
Practice Address - Country:US
Practice Address - Phone:620-725-3779
Practice Address - Fax:620-725-3779
Is Sole Proprietor?:No
Enumeration Date:2011-04-27
Last Update Date:2011-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS14-00639225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant