Provider Demographics
NPI:1053435677
Name:FOLEY, DEBRA
Entity type:Individual
Prefix:
First Name:DEBRA
Middle Name:
Last Name:FOLEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:DEBRA
Other - Middle Name:
Other - Last Name:BAVER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:27309 APPLE ROAD
Mailing Address - Street 2:
Mailing Address - City:WATERFORD
Mailing Address - State:WI
Mailing Address - Zip Code:53185
Mailing Address - Country:US
Mailing Address - Phone:262-331-4397
Mailing Address - Fax:
Practice Address - Street 1:102 N. STATE STREET
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:WI
Practice Address - Zip Code:53167
Practice Address - Country:US
Practice Address - Phone:262-331-4397
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-19
Last Update Date:2007-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI5496-024225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist