Provider Demographics
NPI:1861548752
Name:KOVAL, DEBORAH E (PT)
Entity type:Individual
Prefix:DR
First Name:DEBORAH
Middle Name:E
Last Name:KOVAL
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2330 WELTON PL
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30338-5345
Mailing Address - Country:US
Mailing Address - Phone:770-455-3994
Mailing Address - Fax:770-986-6109
Practice Address - Street 1:2330 WELTON PL
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30338-5345
Practice Address - Country:US
Practice Address - Phone:770-455-3994
Practice Address - Fax:770-986-6109
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-25
Last Update Date:2009-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT008500225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist