Provider Demographics
NPI:1245864875
Name:STRANGE, DEBORAH (PTA)
Entity type:Individual
Prefix:
First Name:DEBORAH
Middle Name:
Last Name:STRANGE
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:DEBORAH
Other - Middle Name:A
Other - Last Name:LAWS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PTA
Mailing Address - Street 1:506 N 5TH ST
Mailing Address - Street 2:
Mailing Address - City:OXFORD
Mailing Address - State:IN
Mailing Address - Zip Code:47971-8699
Mailing Address - Country:US
Mailing Address - Phone:571-332-3070
Mailing Address - Fax:
Practice Address - Street 1:506 N 5TH ST
Practice Address - Street 2:
Practice Address - City:OXFORD
Practice Address - State:IN
Practice Address - Zip Code:47971-8699
Practice Address - Country:US
Practice Address - Phone:571-332-3070
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-22
Last Update Date:2020-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN06003914A225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant