Provider Demographics
NPI:1053436980
Name:PRONZATO, DEBRA (MS, PT)
Entity type:Individual
Prefix:
First Name:DEBRA
Middle Name:
Last Name:PRONZATO
Suffix:
Gender:F
Credentials:MS, PT
Other - Prefix:
Other - First Name:DEBRA
Other - Middle Name:
Other - Last Name:HODGE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:12 OVERLOOK AVE
Mailing Address - Street 2:
Mailing Address - City:WILLOW GROVE
Mailing Address - State:PA
Mailing Address - Zip Code:19090-2722
Mailing Address - Country:US
Mailing Address - Phone:215-659-4174
Mailing Address - Fax:215-658-0215
Practice Address - Street 1:600 S BROAD ST
Practice Address - Street 2:
Practice Address - City:KENNETT SQUARE
Practice Address - State:PA
Practice Address - Zip Code:19348-3346
Practice Address - Country:US
Practice Address - Phone:800-992-9711
Practice Address - Fax:610-925-4579
Is Sole Proprietor?:No
Enumeration Date:2007-03-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT005416-L225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist