Provider Demographics
NPI:1104974351
Name:CHARTASH, DEBBI (PT)
Entity type:Individual
Prefix:
First Name:DEBBI
Middle Name:
Last Name:CHARTASH
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:DEBBI
Other - Middle Name:
Other - Last Name:CHARTASH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PT
Mailing Address - Street 1:4793 BROXBOURNE DR
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30068-5509
Mailing Address - Country:US
Mailing Address - Phone:770-587-4733
Mailing Address - Fax:
Practice Address - Street 1:4793 BROXBOURNE DR
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30068-5509
Practice Address - Country:US
Practice Address - Phone:770-587-4733
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA001129174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist