Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251N0400X | Physical Therapist - Neurology | PT002834 | GA |
NPI | 1255791372 |
---|---|
Provider Name | Dr. Deborah Backus |
First Address | Atlanta, GA 30309-1426 |
Second Address | Atlanta, GA 30309-1426 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/03/2016 |
Last Update Date | 02/03/2016 |