Provider Demographics
NPI:1679806103
Name:GEROW, DEBRA (PTA)
Entity type:Individual
Prefix:MS
First Name:DEBRA
Middle Name:
Last Name:GEROW
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:337 MOUNTAIN RD
Mailing Address - Street 2:
Mailing Address - City:LENHARTSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19534
Mailing Address - Country:US
Mailing Address - Phone:610-562-0935
Mailing Address - Fax:
Practice Address - Street 1:1250 CEDAR CREST BLVD
Practice Address - Street 2:SUITE 110
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18103
Practice Address - Country:US
Practice Address - Phone:610-663-6951
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-09-16
Last Update Date:2009-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PATE007400225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant