Doctor Name: | JENNIFER L STIDHAM |
NPI Number: | 1801292297 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 05004747A |
Business Practice Address: | 1171 W Tipton St Suite L Seymour, IN - 472742793 |
Business Phone Number: | 8125227007 |
Business Fax Number: | 8125227043 |
Mailing Address: | 1171 W Tipton St, Suite L SEYMOUR |
State: | IN |
Postal Code: | 472742793 |
Phone Number: | 8125227007 |
Fax Number: | 8125227043 |
NPI Enumeration Date: | 11/12/2014 |
NPI Last Update Date: | 11/12/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | 05004747A |
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 |