Individual
DEBRA PROCTOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3809 GRAYTON DR, NEW PORT RICHEY, FL 34652-5714
(786) 266-1277
Mailing address
3809 GRAYTON DR, NEW PORT RICHEY, FL 34652-5714
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
15522
FL
Other
Enumeration date
03/26/2015
Last updated
03/26/2015
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