Deborah L. Prementine, LPTA
Individual provider Active NPI Physical Therapy Assistant · Bowdon, GA
NPI 1194064964 · NPPES record last updated Feb 13, 2013
Key facts
- NPI
- 1194064964
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapy Assistant 225200000X
- License
- 000595 (GA)
- Practice address
- 501 Mitchell Ave
Bowdon, GA 30108-1407 - Phone
- (678) 890-9965
- Fax
- (678) 890-8750
- NPI assigned
- Feb 13, 2013
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 000595 | GA | MD | Physical Therapy Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 000595 | GA | Yes |
Addresses
Primary practice location
501 Mitchell Ave
Bowdon, GA 30108-1407
Mailing address
501 Mitchell Ave
Bowdon, GA 30108-1407
Phone (678) 890-9965
Other names
- Deborah L. Prementine
Other providers in Bowdon, GA
- Sarah Lockridge
- Justin D Lovvorn
- Brianna McKey
- Open Horizons Healthcare LLC
- Mike W. Ou
- Robert Chris Salter
- Sims Pharmacy Inc
- Sims Pharmacy Inc
- Southeast Senior Care Mangment Group
- Anna Beam Strain
All providers in Bowdon, GA · Physical Therapy Assistant in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 13, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.