Provider Demographics
NPI:1063542389
Name:STEPHENS, SHEILA (PT)
Entity type:Individual
Prefix:
First Name:SHEILA
Middle Name:
Last Name:STEPHENS
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:PO BOX 1411
Mailing Address - Street 2:
Mailing Address - City:CRAWFORDVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32326-1411
Mailing Address - Country:US
Mailing Address - Phone:850-926-8555
Mailing Address - Fax:850-926-2402
Practice Address - Street 1:2887 CRAWFORDVILLE HWY
Practice Address - Street 2:SUITE 3, DUBREJA PLAZA
Practice Address - City:CRAWFORDVILLE
Practice Address - State:FL
Practice Address - Zip Code:32327
Practice Address - Country:US
Practice Address - Phone:850-926-8555
Practice Address - Fax:850-926-2402
Is Sole Proprietor?:No
Enumeration Date:2007-03-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT17908225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist