Provider Demographics
NPI:1992413389
Name:KASPARIAN, STEPHANIE (PTA)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:
Last Name:KASPARIAN
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5477 BROOK POINT RD
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43611-1402
Mailing Address - Country:US
Mailing Address - Phone:567-249-7028
Mailing Address - Fax:
Practice Address - Street 1:9640 SYLVANIA METAMORA RD
Practice Address - Street 2:
Practice Address - City:SYLVANIA
Practice Address - State:OH
Practice Address - Zip Code:43560-9485
Practice Address - Country:US
Practice Address - Phone:419-724-1200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-14
Last Update Date:2022-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant