Provider Demographics
NPI:1134232937
Name:MCTURK, DEBORAH MCNAIR (OTRL)
Entity type:Individual
Prefix:MRS
First Name:DEBORAH
Middle Name:MCNAIR
Last Name:MCTURK
Suffix:
Gender:F
Credentials:OTRL
Other - Prefix:
Other - First Name:DEBORAH
Other - Middle Name:MCNAIR
Other - Last Name:LYON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1062 RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:VALDOSTA
Mailing Address - State:GA
Mailing Address - Zip Code:31605
Mailing Address - Country:US
Mailing Address - Phone:229-245-9428
Mailing Address - Fax:229-253-8904
Practice Address - Street 1:1062 RIDGE RD
Practice Address - Street 2:
Practice Address - City:VALDOSTA
Practice Address - State:GA
Practice Address - Zip Code:31605
Practice Address - Country:US
Practice Address - Phone:229-245-9428
Practice Address - Fax:229-253-8904
Is Sole Proprietor?:No
Enumeration Date:2006-08-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAOT002364225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist