Provider Demographics
NPI:1336565423
Name:COTTRILL, DEONDRA ALLISON (PHYSICAL THERAPIST A)
Entity Type:Individual
Prefix:MS
First Name:DEONDRA
Middle Name:ALLISON
Last Name:COTTRILL
Suffix:
Gender:F
Credentials:PHYSICAL THERAPIST A
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:1725 N. 5TH STREET
Mailing Address - Street 2:UNION HOSPITAL THERAPY SERVICES
Mailing Address - City:TERRE HAUTE
Mailing Address - State:IN
Mailing Address - Zip Code:47804
Mailing Address - Country:US
Mailing Address - Phone:812-238-7210
Mailing Address - Fax:812-242-3070
Practice Address - Street 1:1725 N. 5TH STREET
Practice Address - Street 2:UNION HOSPITAL THERAPY SERVICES
Practice Address - City:TERRE HAUTE
Practice Address - State:IN
Practice Address - Zip Code:47804
Practice Address - Country:US
Practice Address - Phone:812-238-7210
Practice Address - Fax:812-242-3070
Is Sole Proprietor?:No
Enumeration Date:2014-03-13
Last Update Date:2014-03-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IN06002801A225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant