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Individual

MS. DEBRA G KOON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PT,ATC

Contact information

Practice address
15631 QUAIL PT, NORTHPORT, AL 35475-2614
(205) 349-0995
(205) 349-0995
Mailing address
PO BOX 20429, TUSCALOOSA, AL 35402-0429
(205) 349-0995
(205) 349-0995

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1087
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
51076565
BLUE CROSS BLUE SHIELD AL
AL
01
6410032
UNITEDHEALTH CARE
AL
Enumeration date
05/11/2007
Last updated
07/09/2007
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