Provider Demographics
NPI:1881649499
Name:PHILLIPS, DEBRA E (PTA)
Entity Type:Individual
Prefix:MS
First Name:DEBRA
Middle Name:E
Last Name:PHILLIPS
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:MS
Other - First Name:DEBRA
Other - Middle Name:E
Other - Last Name:DUBOSKY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PTA
Mailing Address - Street 1:3101 EMRICK BLVD
Mailing Address - Street 2:STE 112
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18020
Mailing Address - Country:US
Mailing Address - Phone:610-997-5756
Mailing Address - Fax:610-997-5762
Practice Address - Street 1:3101 EMRICK BLVD
Practice Address - Street 2:STE 112
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18020
Practice Address - Country:US
Practice Address - Phone:610-997-5756
Practice Address - Fax:610-997-5762
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PATE000215L225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant