Provider Demographics
NPI:1306904719
Name:STRAUB, STEPHANIE A (PT)
Entity type:Individual
Prefix:MRS
First Name:STEPHANIE
Middle Name:A
Last Name:STRAUB
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:5300 DERRY ST
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17111-3576
Mailing Address - Country:US
Mailing Address - Phone:717-839-2110
Mailing Address - Fax:717-565-1934
Practice Address - Street 1:100 BRADFORD RD
Practice Address - Street 2:SUITE 210
Practice Address - City:WEXFORD
Practice Address - State:PA
Practice Address - Zip Code:15090-8486
Practice Address - Country:US
Practice Address - Phone:724-940-2323
Practice Address - Fax:724-940-2340
Is Sole Proprietor?:No
Enumeration Date:2006-12-05
Last Update Date:2016-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT017819225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist