Debra M Grande, PT

Individual provider Active NPI Physical Therapist · Chipley, FL

NPI 1003036625 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1003036625
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapist 225100000X
License
PT4767 (FL)
Practice address
877 3Rd St Ste 1
Chipley, FL 32428-1855
Phone
(850) 638-8447
Fax
(850) 638-9217
NPI assigned
Apr 26, 2007
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
PT4767FLMDPhysical Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT4767 FL Yes

Addresses

Primary practice location

877 3Rd St Ste 1
Chipley, FL 32428-1855

Mailing address

877 3Rd St Ste 1
Chipley, FL 32428-1855
Phone (850) 638-8447

Other providers in Chipley, FL

All providers in Chipley, FL · Physical Therapist in Florida

Sources for this page

Verify at the official NPI Registry.