Provider Demographics
NPI:1760536742
Name:CALL, DEBRA LYN (MSPT)
Entity Type:Individual
Prefix:
First Name:DEBRA
Middle Name:LYN
Last Name:CALL
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1827 EVEREST AVE
Mailing Address - Street 2:
Mailing Address - City:O FALLON
Mailing Address - State:MO
Mailing Address - Zip Code:63366-4808
Mailing Address - Country:US
Mailing Address - Phone:636-240-1622
Mailing Address - Fax:636-379-3181
Practice Address - Street 1:1827 EVEREST AVE
Practice Address - Street 2:
Practice Address - City:O FALLON
Practice Address - State:MO
Practice Address - Zip Code:63366-4808
Practice Address - Country:US
Practice Address - Phone:636-240-1622
Practice Address - Fax:636-379-3181
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO1020932251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics