Most Relevant Information
Provider Data
| NPI Number: | 1003478900 |
| Provider Name: | DOUGLAS REED STEPHENSON PTA |
| Entity Type: | Individual |
| Taxonomy Code: | 225200000X |
| Specialty: | Physical Therapy Assistant |
| License Number: | A00875 |
Most Important Dates
| Enumeration Date: | 07/01/2019 |
| Last Updated: | 07/01/2019 |
Provider Practice Location
129 HILLCREST DR
BYRDSTOWN
TN
385492326
Practice Location Phone/Fax
| Phone: | 9318643162 |
| Fax: |
Provider Mailing Location
38 WORLEY RANCH RD
MONTICELLO
KY
426333328
Provider Mailing Phone/Fax
| Phone: | 6062782186 |
| Fax: |