Provider Demographics
NPI:1861626954
Name:SIPES, DEANA MURLAS (PT)
Entity type:Individual
Prefix:MRS
First Name:DEANA
Middle Name:MURLAS
Last Name:SIPES
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 1:2003 BURNTLEAF PL
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27410-2881
Mailing Address - Country:US
Mailing Address - Phone:336-282-2562
Mailing Address - Fax:336-288-7312
Practice Address - Street 1:2003 BURNTLEAF PL
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27410-2881
Practice Address - Country:US
Practice Address - Phone:336-282-2562
Practice Address - Fax:336-288-7312
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-05
Last Update Date:2009-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1924225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1924OtherPHYSICAL THERAPY