Doctor Name: | JULIE A STEVENSON |
NPI Number: | 1154568301 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PT |
License Number: | 5501013744 |
Business Practice Address: | 4351 24th Ave Suite 1 Fort Gratiot, MI - 480594506 |
Business Phone Number: | 8103857405 |
Business Fax Number: | 8103857420 |
Mailing Address: | 4351 24th Ave, Suite 1 FORT GRATIOT |
State: | MI |
Postal Code: | 480594506 |
Phone Number: | 8103857405 |
Fax Number: | 8103857420 |
NPI Enumeration Date: | 01/09/2009 |
NPI Last Update Date: | 07/17/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QP2000X |
License Number: | 5501013744 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MI |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Physical Therapy |
Taxonomy Definition: |