| NPI | 1235322769 |
|---|---|
| Former Name | STEPHANIE LYNN STRACK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: AR PT 2892) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: GA PT9349) |
| 225100000X Physical Therapist (Licence: MO 2014038484) | |
| Enumeration Date | 2007-08-17 |
| Last Update Date | 2015-01-19 |