Most Relevant Information
Provider Data
| NPI Number: | 1003177114 |
| Provider Name: | THERESA A STANLEY OTR |
| Entity Type: | Individual |
| Taxonomy Code: | 225X00000X |
| Specialty: | Occupational Therapist |
| License Number: | L1352297 |
Most Important Dates
| Enumeration Date: | 06/05/2012 |
| Last Updated: | 06/05/2012 |
Provider Practice Location
968 S VAN DYKE RD
BAD AXE
MI
484139712
Practice Location Phone/Fax
| Phone: | 9892698700 |
| Fax: | 9892698715 |
Provider Mailing Location
968 S VAN DYKE RD
BAD AXE
MI
484139712
Provider Mailing Phone/Fax
| Phone: | 9892698700 |
| Fax: | 9892698715 |