Individual
MRS. DEBRA J. MIMS
Active
Individual
MRS. DEBRA J. MIMS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
P.T.
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT003220
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000608979C
—
GA
05
—
10058027
—
GA
05
—
339863
—
GA
01
—
52262717
BCBS
GA
Enumeration date
12/26/2006
Last updated
02/02/2021
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