| Doctor Name: | MRS. PATRICIA J STACKHOUSE |
| NPI Number: | 1467670646 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | P.T. |
| License Number: | 05001279A |
| Business Practice Address: | 1111 Ronald Reagan Pkwy Suite Mg214 Avon, IN - 461237085 |
| Business Phone Number: | 3172173070 |
| Business Fax Number: | 3172173073 |
| Mailing Address: | 7 E 70th St, INDIANAPOLIS |
| State: | IN |
| Postal Code: | 462201001 |
| Phone Number: | 3172518686 |
| Fax Number: | |
| NPI Enumeration Date: | 04/23/2007 |
| NPI Last Update Date: | 01/14/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | 05001279A |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IN |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |