Provider Demographics
NPI:1306355268
Name:LIGHTLE, STEPHANIE SLOAN (PT)
Entity type:Individual
Prefix:MRS
First Name:STEPHANIE
Middle Name:SLOAN
Last Name:LIGHTLE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:STEPHANIE
Other - Middle Name:LYNN
Other - Last Name:SLOAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:8319 S GARLAND CIR
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80128-9279
Mailing Address - Country:US
Mailing Address - Phone:614-439-0329
Mailing Address - Fax:
Practice Address - Street 1:7777 W 38TH AVE UNIT A124
Practice Address - Street 2:
Practice Address - City:WHEAT RIDGE
Practice Address - State:CO
Practice Address - Zip Code:80033-6170
Practice Address - Country:US
Practice Address - Phone:303-940-0757
Practice Address - Fax:303-423-6551
Is Sole Proprietor?:No
Enumeration Date:2017-09-22
Last Update Date:2017-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist