Provider Demographics
NPI:1184755993
Name:PHILLIPS, DEBORAH ANNE (PT)
Entity type:Individual
Prefix:MRS
First Name:DEBORAH
Middle Name:ANNE
Last Name:PHILLIPS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:337 WARRICK DR
Mailing Address - Street 2:
Mailing Address - City:SEVEN FIELDS
Mailing Address - State:PA
Mailing Address - Zip Code:16046-8015
Mailing Address - Country:US
Mailing Address - Phone:724-776-2262
Mailing Address - Fax:
Practice Address - Street 1:114 SKYLINE LN
Practice Address - Street 2:
Practice Address - City:BUTLER
Practice Address - State:PA
Practice Address - Zip Code:16001-8762
Practice Address - Country:US
Practice Address - Phone:724-283-3198
Practice Address - Fax:724-283-5945
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT013176L225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0018884650003Medicaid