Provider Demographics
NPI:1427305614
Name:STRAYER, STACEY LYNN (DPT)
Entity type:Individual
Prefix:
First Name:STACEY
Middle Name:LYNN
Last Name:STRAYER
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7753 COX LN # 31
Mailing Address - Street 2:
Mailing Address - City:WEST CHESTER
Mailing Address - State:OH
Mailing Address - Zip Code:45069-6549
Mailing Address - Country:US
Mailing Address - Phone:513-802-1929
Mailing Address - Fax:888-972-7349
Practice Address - Street 1:715 CONGRESS PARK DR
Practice Address - Street 2:
Practice Address - City:CENTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:45459-4044
Practice Address - Country:US
Practice Address - Phone:937-660-7638
Practice Address - Fax:888-972-7349
Is Sole Proprietor?:No
Enumeration Date:2012-08-07
Last Update Date:2016-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT. 013731225100000X, 2251S0007X, 2251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251S0007XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistSports
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic