Provider Demographics
NPI:1124740659
Name:STAHLER, DAVID TERRELL (DPT)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:TERRELL
Last Name:STAHLER
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:212 RETREAT VLG
Mailing Address - Street 2:
Mailing Address - City:ST SIMONS IS
Mailing Address - State:GA
Mailing Address - Zip Code:31522-2403
Mailing Address - Country:US
Mailing Address - Phone:912-638-1444
Mailing Address - Fax:912-638-0077
Practice Address - Street 1:212 RETREAT VLG
Practice Address - Street 2:
Practice Address - City:ST SIMONS IS
Practice Address - State:GA
Practice Address - Zip Code:31522-2403
Practice Address - Country:US
Practice Address - Phone:912-638-1444
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-12
Last Update Date:2022-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT016199225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist