Provider Demographics
NPI:1275717456
Name:THOMAS WARE, STEPHANIE RENEE (PT)
Entity type:Individual
Prefix:DR
First Name:STEPHANIE
Middle Name:RENEE
Last Name:THOMAS WARE
Suffix:
Gender:
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3708 3RD PL NE
Mailing Address - Street 2:
Mailing Address - City:CENTER POINT
Mailing Address - State:AL
Mailing Address - Zip Code:35215-1400
Mailing Address - Country:US
Mailing Address - Phone:251-458-2831
Mailing Address - Fax:
Practice Address - Street 1:3708 3RD PL NE
Practice Address - Street 2:
Practice Address - City:CENTER POINT
Practice Address - State:AL
Practice Address - Zip Code:35215-1400
Practice Address - Country:US
Practice Address - Phone:251-458-2831
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-24
Last Update Date:2025-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALPTH5091225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL529917620OtherMEDICAID GROUP
ALDB9027OtherMEDICARE RAILROAD
ALK531OtherMEDICARE GROUP