Provider Demographics
NPI:1386919504
Name:SCHALL, STEPHEN MATTHEW (LPTA, LMT)
Entity type:Individual
Prefix:MR
First Name:STEPHEN
Middle Name:MATTHEW
Last Name:SCHALL
Suffix:
Gender:M
Credentials:LPTA, LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2350 PHILLIPS RD
Mailing Address - Street 2:APT 3202
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32308-5346
Mailing Address - Country:US
Mailing Address - Phone:757-777-2258
Mailing Address - Fax:
Practice Address - Street 1:2350 PHILLIPS RD
Practice Address - Street 2:APT 3202
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32308-5346
Practice Address - Country:US
Practice Address - Phone:757-777-2258
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-03-21
Last Update Date:2012-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPTA22466225200000X
VA2306602672225200000X
FLMA 67352225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist