Most Relevant Information
Provider Data
| NPI Number: | 1003420068 |
| Provider Name: | KAYLA JEANNE STADIUS PT, DPT, EP-C |
| Entity Type: | Individual |
| Taxonomy Code: | 225100000X |
| Specialty: | Physical Therapist |
| License Number: | 36241 |
Most Important Dates
| Enumeration Date: | 09/06/2020 |
| Last Updated: | 10/10/2023 |
Provider Practice Location
3055 COUNTY ROAD 210 W STE 110
ST JOHNS
FL
322597001
Practice Location Phone/Fax
| Phone: | 9046340640 |
| Fax: | 9046340203 |
Provider Mailing Location
6800 SOUTHPOINT PKWY STE 300
JACKSONVILLE
FL
322168203
Provider Mailing Phone/Fax
| Phone: | 9046340640 |
| Fax: |