Provider Demographics
NPI:1922174069
Name:MARTIN, DEBORAH ROSSER (PT)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:ROSSER
Last Name:MARTIN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:DEBBIE
Other - Middle Name:ROSSER
Other - Last Name:MARTIN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2407 MORRIS CLOSE
Mailing Address - Street 2:
Mailing Address - City:MURFREESBORO
Mailing Address - State:TN
Mailing Address - Zip Code:37130
Mailing Address - Country:US
Mailing Address - Phone:615-895-0085
Mailing Address - Fax:
Practice Address - Street 1:420 N UNIVERSITY ST
Practice Address - Street 2:NHC MURFREESBORO
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37130
Practice Address - Country:US
Practice Address - Phone:615-893-2602
Practice Address - Fax:615-890-1224
Is Sole Proprietor?:No
Enumeration Date:2006-11-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNTN853225100000X
FLPT3002225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist