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Individual

DEBORA ANN DUCKETT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
5539 HWY 47, CHASE CITY, VA 23924-3727
(434) 372-4063
Mailing address
503 CARDINAL CT, SOUTH BOSTON, VA 24592-1758
(434) 572-2007

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2306000664
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
49-5380
VA
Enumeration date
04/20/2009
Last updated
04/20/2009
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