Provider Demographics
NPI:1992389332
Name:BIBLE, STACY (DPT)
Entity type:Individual
Prefix:
First Name:STACY
Middle Name:
Last Name:BIBLE
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:STACY
Other - Middle Name:
Other - Last Name:SONES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:1314 N WESTVIEW DR
Mailing Address - Street 2:
Mailing Address - City:DERBY
Mailing Address - State:KS
Mailing Address - Zip Code:67037-2919
Mailing Address - Country:US
Mailing Address - Phone:620-440-9297
Mailing Address - Fax:
Practice Address - Street 1:1410 N WOODLAWN BLVD STE D
Practice Address - Street 2:
Practice Address - City:DERBY
Practice Address - State:KS
Practice Address - Zip Code:67037-2931
Practice Address - Country:US
Practice Address - Phone:316-202-0970
Practice Address - Fax:316-202-0971
Is Sole Proprietor?:No
Enumeration Date:2021-05-11
Last Update Date:2021-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS11-06807225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist