Individual
DEBRA JEAN MAXTED
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
420 SE MYRA ROAD, COLLEGE PLACE, WA 99324
(509) 529-4480
Mailing address
53335 E HWY 26, PO BOX 1213, SANDY, OR 97055
(503) 622-5882
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
P160234599
WA
Other
Enumeration date
09/13/2011
Last updated
09/13/2011
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